What do I ask? | Prepare
What do I need to consider when choosing which questions to ask?
• Keep questions clear, singular, neutral, include time frames when applicable, and appropriate for your individual patient. 1
Clear: Be straightforward but non-judgemental in your questions so the patient doesn't have to guess at what you're asking.
Singular: Ask one question at a time to make sure you give the patient the opportunity to answer. Questions like, "Do your friends vape and do they pressure you to vape with them?" can be unclear and more difficult to answer than singular question.
Neutral: Avoid loaded words/phrases and stereotypes that might lead the patient to provide the most "desirable" answer. Asking,“During the last month, you didn't vape again did you?” will discourage patients from admitting that they may have relapsed. Instead, "During the last month, how many days, if any, did you vape?" is a non-judemental rephrasing that will be more likely to receive an honest response.
Time frame: Adolescent behaviors may change frequently, so include a time frame when applicable. "Do you vape?", "Have you ever vaped?", and "Have you vaped in the past month?" will likely all get different responses from the patient. Make sure your questions match what you want to know.
Appropriate: Consider the identities and experiences of your patient when deciding which questions to ask.
- Hulley, Stephen B., ed. Designing clinical research. Lippincott Williams & Wilkins, 2007.
Should I ask them questions directly or have them fill out a questionnaire?
• Consider whether you already have an established relationship with the patient, your time constraints, and the patient's comfort level when deciding whether or not to ask your patients verbally or via questionnaire.
• The Center for Adolescent Substance Abuse Research (CeASAR) at Boston Children's Hospital, for example, recommends administering their screening tool via patient-administered questionnaires.
"Research has shown that adolescents report greater comfort and likelihood of honesty with self-administered questionnaires (electronic versions or on paper) compared to face-to-face interviews. The self-administered version is also more time-efficient to administer than an interview. Therefore, we recommend the use of the Self-administered Questionnaire whenever possible, under conditions that protect patient privacy and confidentiality. The responses can then be used by the healthcare provider during the appointment to facilitate brief counseling."
What terminology should I use?
• Patients may use any number of terms to refer to e-cigarettes such as vapes, mods, or by device name (i.e. JUUL, PuffBar).
• If you can, find out what devices and brands are popular among youth in your community to familiarize yourself with local trends.
• When asking about use, list a few of the common devices. If your patient uses one term specifically, try to use that same term when speaking to them.
"Have you ever used vaping devices before, like JUUL or PuffBar?"
Confidentiality and Minor Consent
• Best practice recommendations (and most state's laws) recognize the importance of conditional confidentiality* for young people seeking health and behavioral health related services.
• For "sensitive services” such as reproductive/sexual health care and behavioral health care not requiring psycho-active medications, young people under 18 years of age can both provide consent and expect confidentiality (eg. their care will not be shared with parents or adult guardians without their permission) related to such services.
• This approach recognizes that some young people will likely forego needed care if they do not have some level of confidentiality.
*conditional confidentiality refers to the fact that confidentiality can be broken if certain conditions are met (typically, revelation of risk of harm to self or harm to/from others). Youth are made aware of these conditions prior to the provision of the care.
Read more in our Further Resources: Confidentiality and Minor Consent page.