Promoting Healthy Behaviors in Teens
Popular culture tempts teens to engage in activities that may be beyond their abilities or comfort level, and as a result, they may be exposed to health risks, injury and even death. As adolescents respond to the latest online challenge or social trend, health care providers are challenged to keep up with the behaviors that pose the greatest danger and how to address them in primary care.
Read on to learn about the top five behaviors associated with teen morbidity and mortality and get tips on how to counsel young people during preventive medical checkups.
- 45.7% of Texas high school students rarely or never wore a seat belt as a passenger, according to a 2021 survey by the Centers for Disease Control and Prevention (CDC).
- 38.1% texted or emailed while driving (Ibid).
- Nearly 21% of Texas high school students reported being in a physical fight in the previous year (Ibid.).
- 11% of U.S. high school students experienced sexual violence (kissing, touching or being forced to have sexual intercourse that they did not want to do).
- In 2023, 10% of high school students used electronic cigarettes in the month before a federal survey (CDC, 2023).
- Alcohol is one of the most abused substances among teens. Nearly 25% of Texas high school students had at least one drink of alcohol during the previous month (CDC, 2021).
- 13.9% of Texas high school students were offered, sold or given an illegal substance by someone on school property (CDC, 2021).
- 92% of unintentional opioid deaths in youth are ages 15 through 17 years (National Center for Fatality Review and Prevention, 2024).
- Sexting is highly correlated with increased emotional distress as well as with sexual activity, having multiple sexual partners and not using contraception (Mori, Temple, Browne, & Madigan, 2019).
- 23% of Texas high school students engage in sexual intercourse and 50% of them did not use a condom during their most recent sexual intercourse (CDC, 2021).
Clinical Case Example
Abby is in your office for her 15-year Texas Health Steps preventive medical checkup. Screening shows she is in good health, and she reports being a straight-A student. “I’m also on the cheer squad and I love it,” she says.
Her comment offers an excellent opportunity to inquire about possible safety risks associated with the cheer squad.
Provider: Abby, congratulations on being chosen for the cheer team. Do you mind if I ask how you get home after games?
Abby: Oh, one of the senior girls has a new car and a bunch of us usually squeeze into it to get home. She’s 18, so she’s a good driver.
Provider: Is there a seat belt available for each of you?
Abby: Gosh, I’m not sure. We don’t bother with them because we end up sitting on each other’s laps. It’s crowded but we make it work. When a car with football players comes by, one of us leans out the window to try to touch hands with them. Lots of cheer squads do it. Someone always posts a funny video of the midair handshake.
Provider: Abby, let’s talk about how you can stay safe in a vehicle because, unfortunately, teens your age are most at risk for being in a fatal car crash.
Abby: Wait, what do you mean? We’ve never been in a crash.
Provider: Abby, it’s very important for everyone in the car to wear a seat belt. Did you know wearing a seat belt is required by law in Texas? It’s illegal for anyone in that car to be unbuckled, front or back seat, while the car is moving.
Abby: No, I didn’t know. I don’t want to get in trouble. And I don’t want to get hurt, either.
Provider: I’m glad we’re talking about this. The seat belt law helps protect everyone in your car as well people in other cars, so everyone gets home safely. It’s the same reason there’s a law against drivers using their phone while they are driving.
Abby: I hadn’t thought about it like that. But I’m only catching a ride. What can I do about it?
Provider: That’s a great question, Abby. How about we brainstorm a few ideas for how to make sure you get home safely after the next game?
Why It Matters
Physical, cognitive and social development influence risk-taking behavior among adolescents. Risky behaviors contribute to youth morbidity and mortality, and your goal as a health care provider is to help young patients identify and avoid unsafe behaviors. Always remember to apply the Texas Health Steps Periodicity Schedule to conduct routine screenings for high-risk behaviors. Adolescents often need guidance to distinguish between positive risks and those that are unsafe, such as prank-and-post trends. Taking time to discuss high-risk behaviors with your adolescent patients can save lives.
References
American Academy of Pediatrics, healthychildren.org. (2023). Dangerous Social Media Challenges: Understanding Their Appeal to Kids.
Centers for Disease Control and Prevention. (2023). Tobacco Product Use Among Product U.S. Middle and High School Students—National Youth Tobacco Survey, 2023. Morbidity and Mortality Weekly Report, 72(44):1173-1182.
Centers for Disease Control and Prevention. (2021). Youth Risk Behavior Survey—Texas 2021 Results.
Centers for Disease Control and Prevention. (2021). Youth Risk Behavior Survey—United States 2021 Results.
Mori, C., Temple, J., Browne, D., & Madigan, S. (2019). Association of Sexting with Sexual Behaviors and Mental Health Among Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatrics, 173(8):770-779.
National Center for Fatality Review and Prevention. 2024. Opioid-Related Deaths, Ages 1 to 17.
National Institute of Mental Health. (2023). The Teen Brain: 7 Things to Know.
Texas Health and Human Services Commission. (2025). Texas Health Steps Medical Providers. Periodicity Schedule.