Recommended Assessments and Interventions for an 18-Year-Old Male Family Medicine Check-up
An 18-year-old male should receive a comprehensive health assessment focusing on preventive care, risk factor identification, and age-appropriate screenings to optimize health outcomes.
Core Assessment Components
Medical History
- Tobacco, alcohol, and substance use screening
- Sexual history and risk assessment for STIs
- Diet and exercise habits
- Mental health screening for depression and anxiety
- Family history of premature cardiovascular disease, cancer, and genetic conditions
- Medication review (prescription and non-prescription)
- Review of systems focusing on adolescent/young adult concerns
Physical Examination
- Blood pressure measurement
- Height and weight with BMI calculation
- Complete physical examination with particular attention to:
- Skin examination
- Cardiovascular examination
- Testicular examination
- Assessment for scoliosis
- Vision screening
- Oral health assessment
Laboratory and Screening Tests
- No routine laboratory tests are recommended for healthy 18-year-old males without risk factors 1
- Consider lipid screening if family history of premature cardiovascular disease
- STI screening based on sexual history and risk factors
Preventive Interventions
Immunizations
- Review and update immunization status according to the Advisory Committee on Immunization Practices guidelines:
- Verify completion of HPV vaccine series (if not completed)
- Meningococcal vaccine (including MenB for college students)
- Annual influenza vaccine
- Tdap or Td booster if due
- COVID-19 vaccination as per current guidelines
Counseling
- Sexual health counseling including contraception and STI prevention
- Substance use prevention (alcohol, tobacco, vaping, marijuana, other drugs)
- Injury prevention:
- Seat belt use
- Helmet use for bicycling and other activities
- Avoiding distracted driving and driving under the influence
- Mental health and stress management
- Healthy diet and physical activity (150 minutes of moderate-intensity exercise weekly)
- Sun protection
Special Considerations
Mental Health
- Screen for depression using validated tools (e.g., PHQ-9)
- Assess for anxiety, suicidal ideation, and other mental health concerns
- Evaluate school/work performance and social functioning
Sexual Health
- Confidential discussion about sexual activity, orientation, and gender identity
- STI screening based on risk factors
- HPV vaccination completion if not already done
Transition to Adult Care
- Discuss transition to adult healthcare responsibilities
- Encourage self-management of healthcare needs
- Provide guidance on accessing healthcare services independently
Common Pitfalls to Avoid
Overlooking mental health assessment: Depression and anxiety often emerge during late adolescence and early adulthood.
Neglecting confidential discussions: Ensure private time without parents present to discuss sensitive topics like substance use and sexual health.
Missing opportunities for health education: This visit is crucial for establishing healthy behaviors that may persist throughout adulthood.
Focusing only on physical health: A comprehensive approach addressing psychosocial development is essential at this transitional age.
Failing to address risk-taking behaviors: Motor vehicle accidents, substance use, and risky sexual behaviors are leading causes of morbidity and mortality in this age group.
While some guidelines suggest routine screening for certain genetic conditions in specific populations, these are not universally recommended for all 18-year-old males during routine check-ups 2. The focus should be on personalized risk assessment based on family history and individual risk factors.
By addressing these key components, the family medicine check-up can establish a foundation for healthy behaviors and preventive care that will benefit the young man throughout adulthood.