Observational study of audio-recorded conversations between 253 adolescents ( mean age , 14.3 years ; 53 % female ; 40 % white ; 47 % African American ) and 49 physicians ( 82 % pediatricians ; 84 % white ; 65 % female ; mean age , 40.9 years ; mean [ SD ] duration in practice , 11.8 [ 8.7 ] years ) coded for sexuality content at 11 clinics ( 3 academic and 8 community-based practices ) located throughout the Raleigh/Durham , North Carolina , area .