The ASSESS program provides tools to enhance risk-reduction
communication between health care providers and teens while in a
physicians office or clinic setting. A randomized controlled behavioral
intervention trial of the program was conducted in the metropolitan
Washington, DC area between 1995 and 1997. The trial involved 19
physicians at five primary care pediatric practices, and 215 teens, aged
After obtaining consent from both the teen and parent(s), researchers
randomly assigned the teen to either the intervention (n=105) or the
control group (n=114). Control group teens received their usual care
health examination. Intervention group teens listened to a 14-minute
audiotape (wearing headphones for privacy) and answered 11 risk-related
questions on the ASSESS Answer Sheet (that did not contain the
questions). With the parent out of the room, the physician used
program materials (answer sheets, pamphlets, and an ASSESS Pyramid
icebreaker) to encourage the teen to discuss risk behaviors and their
answers on the Answer Sheet. The physician used role-play strategies to
encourage the teen to practice refusing risky behaviors.
All participants were given a face-to-face exit interview following their
checkup to determine how many sexual topics they had discussed with
their health care provider. Telephone follow-up interviews were
conducted at three months and nine months.
Study findings showed that ASSESS program materials had a positive
impact on adolescent-reported discussion with the physician about sex.
More intervention teens reported discussion on sexual topics with their
physicians than did their control group counterparts. The program also
had a positive impact on young adolescent knowledge about HIV
transmission and attitudes towards condom use. At three-month follow-up,
more sexually active teens reported condom use in the intervention
group than the control group. While more vaginal intercourse was also
reported in the intervention group than the control group, this was not
true of overall sexual intercourse (including anal and oral). At nine
months, there were no group differences in sexual behavior; however,
more signs of STDs were reported by the control than the intervention
ASSESS is suitable for use in physician and clinic
offices (for routine general health examinations or annual physical exams as required for participation in sports),
as well as school and STD-related clinics.
The original intervention sample of 215 young
adolescents aged 12-15 included 107 males and 108 females.
More than half of the participants (65%) were African-American, 19% were Caucasian, 7% were Hispanic, and 13%
This single-session, two-component intervention is
designed to be offered while participants wait for their scheduled general health check up, and continued in the
physicians office without a parent present.
The first part of the intervention involves the participant listening to a
14-minute audiotape and answering personal risk-related questions.
The physician uses the color-coded responses to the questions to guide
the private discussion that follows.
The ASSESS program package includes a 15-minute
videotape of a simulated ASSESS visit for use as on-site training. In addition, the ASSESS program binder provides
detailed tips on implementing the
program and using the communication tools during patient visits.
Although the original intervention focused on primary care physicians to
deliver the intervention, you may choose to include physician assistants,
nurse practitioners and other health professionals among those who
administer ASSESS in your setting.