Calling the Shots: Primary Care Providers Discuss Addressing Health-Risk Behaviors During Sports Physicals

Introduction: We sought to describe primary care providers’ perceived barriers and facilitators to addressing health-risk behaviors during preparticipation examinations (PPEs; i.e., “sports physicals”). Methods: From October 2014 to September 2015, we conducted semistructured interviews with a purposive sample of 12 pediatric and family nurse practitioners and seven pediatricians serving diverse patient populations in central Texas. Interviews were transcribed and analyzed using content analysis to identify salient themes. Results: Providers discussed interrelated barriers to addressing risk behaviors during PPEs at interpersonal, family, clinic, and policy levels. Providers described greater barriers to addressing risk behaviors in group-based settings (e.g., in a school gymnasium) than in private practice. Participants also discussed facilitators and gave examples of strategies for effectively addressing health-risk behaviors during PPEs. Discussion: Findings suggest changes for systems (e.g., billing policies) and clinics (e.g., providing private spaces) and provider training to support the routine use of PPEs for addressing these key threats to adolescent health.