Table 1.

Provider recommendations on how to initiate screening of pornography use

All routine visits should include52	Discussion about sex and sexuality. Screening for high-risk sexual behaviour. Allowing space for teens to ask questions and gather accurate and safe resources.
If screening is positive for pornography use7	History of pornography use Define the specific behaviour Assess duration (ie, when did it start), intensity (ie, violent, soft porn) and frequency (ie, how often used) Identify symptoms of current behaviour and how it is interfering in day-to-day functioning. Which specific areas of functioning are impacted by pornography (ie, intrapersonal, interpersonal, sleep, academic performance, mood lability and physical health (neck or genital pain).
	The function of the behaviour Help patient identify the function of the behaviour Some examples would be: avoidance, boredom, negative affect management, emotion regulation and socialisation.
	Past mental health/physical health history Review all former and current symptoms, diagnoses and treatments Research shows that there are higher rates of mental health diagnoses and family challenges with teens engaging in pornography.
	Review/assess social and developmental history Developmental milestones Academic History (learning disorders, 504 Plans). Social history (ie, friends, acquaintances, significant others, social anxiety, social isolation, bullying). Family history (med and psych hx, involvement, substance abuse, abuse, neglect).
How PCP’s can foster parent–child communication about pornography51	Encourage early parental education at home about: sexuality contraception and pornography. Discuss strategies for promoting healthy and safe use of pornography. Make sure that education and discussion is consistent with ‘family’s attitudes, values, beliefs and circumstances’. Discuss strategies for promoting healthy and safe use of pornography. Help families use reputable sources of information.

PCP, primary care provider.