P0668 - Adolescent Health Status in an Underserved Community Along the U.S.-Mexico Border

Program Goals: A Preparticipation Physical Evaluation (PPE), more commonly referred to as a sports physical, is a clinical assessment of an adolescent’s medical eligibility for participation in sports and certain extracurricular activities. The AAP recommends that the primary care provider carries out PPEs when possible. In underserved areas, however, this recommendation may need to be adjusted to provide culturally appropriate care, and thus remove barriers that prevent adolescents from participating in school and local sports programs. As such, a medical student run clinic (MSRC) hosts annual Sports Physical Drives (SPDs) for adolescents in an unincorporated, low-income area near the U.S.-Mexico border (El Paso-Juarez). At these SPDs, families wait for hours for PPEs, suggesting a mass need for adolescent health services. To further investigate gaps and opportunities for adolescent healthcare in the area, we analyzed demographic and health information collected at previous SPDs.

Evaluation: A retrospective review of medical records was performed using University Interscholastic League (UIL) Texas Preparticipation Physical Evaluation Medical History Forms. These forms were utilized to document history and physical exam findings for students during the three most recent MSRC SPDs. Variables that were examined include sex, age, zip code, grade, school district, name of personal physician (if any), height, weight, blood pressure, and visual acuity and correction as well as past medical history and family history.

Results: Data were collected from 315 UIL Forms from 2017 to 2019. Study subjects ranged from ages 11 to 17; there were 166 female and 149 male participants. Mean blood pressure was 111/70, with 1 subject reporting high blood pressure and/or high cholesterol. Additionally, 80 (25.4%) adolescents reported eye or vision problems in comparison to 133 (61.9%) who had corrected vision during physical examination. A total of 238 (75.6%) subjects named a personal physician or clinic. Yet, 13 (6.0%) answered “yes” to being under the care of a physician, and 22 (7.0%) stated medication use. Additionally, calculations for BMI percentiles demonstrate a negatively skewed distribution with 150 (47.6%) overweight or obese subjects. However, only 63 (20%) participants reported a desire to weigh differently from their current weight.

Discussion: The findings highlight unique aspects of border health as well as possible gaps in adolescent health care in the local area. The discrepancies in responses demonstrate that patients and parents may not understand some of the questions. There is a need for accessible translated forms so patients can answer the questions accurately and receive appropriate health education and health literacy materials. Further analysis of the responses suggests the possibility that families are seeking care outside of local providers, including across the border in Mexico. Finally, the distribution of BMI percentiles indicates a need for local intervention on childhood obesity and associated health risks.