Clinical preventive services for adolescents: facing the challenge of proving 'an ounce of prevention is worth a pound of cure'.

摘要

After drafting this piece, I found, with chagrin, an editorial by my esteemed colleague George Patton quoting this same 700-year-old dictum, "an ounce of prevention is worth a pound of cure" and citing its original source [1]. The dictum neatly states that both health and economic benefits are likely to accrue from preventive interventions. Preventable consequences of risk-taking behaviors, mental health disorders, accidents, and injuries dominate the causes of death and disease in the adolescent and young adult age-group [2-4]; hence, prevention has long been a major guiding principle in adolescent health care. Yet, the evidence for health and cost benefits arising from preventive interventions targeting risky behaviors in primary care is only newly emerging [5,6]. Early position papers on adolescent preventive services outline that, although necessary, effectiveness studies would take time to run and should not delay implementation efforts to address human suffering [2,3]. However, with increasing time, resource, and cost constraints on primary care, there is a mounting need to tackle the challenges in gaining evidence to help prioritize the most effective interventions [5,7].