Young peoples’ perspectives about care in a youth-friendly general practice
Eileen McKinlay 1 2 , Sonya Morgan 1 , Sue Garrett 1 , Abby Dunlop 1 , Sue Pullon 1
+ Author Affiliations
- Author Affiliations
1 Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
2 Corresponding author. Email: eileen.mckinlay@otago.ac.nz
Journal of Primary Health Care 13(2) 157-164 https://doi.org/10.1071/HC20134
Published: 24 May 2021
Journal Compilation © Royal New Zealand College of General Practitioners 2021 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: Youth health outcomes are poor in New Zealand and have a life-long impact on individuals, whānau (family) and society. Little is known about how young people view their experiences of general practice care despite it being the most common place to access health care.
AIM: This study sought to explore young peoples’ experiences of care in a selected, youth-friendly general practice.
METHODS: In-depth individual interviews with six young people.
RESULTS: Four themes were identified from young peoples’ narratives in relation to their experiences of general practice care: going to the doctor is not easy for a young person; the attributes of staff make all the difference; specific youth-friendly consultation practices help young people; and a youth-friendly physical environment can help young people access services and feel safe.
DISCUSSION: Even though the study general practice had explicitly instituted youth-friendly initiatives, including offering no-charge consultations and specialist staff members, young people still described considerable barriers to attendance. Many barriers are practice-based and could be modified by staff training, provision of further youth care staff roles and consideration of environmental changes. Other barriers such as waiving prescription costs need government funding.
KEYwords: Adolescent; adolescent health services; general practice; health services accessibility; primary health care; qualitative research; quality improvement; young people; youth-friendly.
References
[1] Tylee A, Haller DM, Graham T, et al. Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet. 2007; 369 1565–73.| Youth-friendly primary-care services: how are we doing and what more needs to be done?Crossref | GoogleScholarGoogle Scholar | 17482988PubMed |
[2] World Health Organization. Adolescent friendly health services, an agenda for change. Geneva: World Health Organization; 2002.
[3] World Health Organization. Making health services adolescent friendly: developing national quality standards for adolescent-friendly health services. Geneva: World Health Organization; 2012.
[4] Patton GC, Sawyer SM, Santelli JS, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016; 387 2423–78.
| Our future: a Lancet commission on adolescent health and wellbeing.Crossref | GoogleScholarGoogle Scholar | 27174304PubMed |
[5] Statistics New Zealand. Subnational population estimates by age and sex, at 30 June 1996–2020. [cited 2020 November 17]. Available from: http://nzdotstat.stats.govt.nz/wbos/Index.aspx?DataSetCode=TABLECODE7979#
[6] Innocenti UNICEF. Worlds of Influence: understanding what shapes child well-being in rich countries. Innocenti Report Card 16. Innocenti: Florence; 2020.
[7] Denny S, Lewycka S, Utter J, et al. The association between socioeconomic deprivation and secondary school students’ health: findings from a latent class analysis of a national adolescent health survey. Int J Equity Health. 2016; 15 109
| The association between socioeconomic deprivation and secondary school students’ health: findings from a latent class analysis of a national adolescent health survey.Crossref | GoogleScholarGoogle Scholar | 27422160PubMed |
[8] Fleming T, Elvidge J. Youth health services literature review. Waitemata District Health Board; 2010.
[9] Clark TC, Fleming T, Bullen P, et al. Youth’12 Overview: the health and wellbeing of New Zealand secondary school students in 2012. Auckland, New Zealand: The University of Auckland; 2013.
[10] Craig E, Adams J, Oben G, et al. The health status of children and young people in New Zealand. Dunedin: New Zealand Child and Youth Epidemiology Service, University of Otago; 2013.
[11] McGorry P, Bates T, Birchwood M. Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry Suppl. 2013; 202 s30–s5.
| Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK.Crossref | GoogleScholarGoogle Scholar |
[12] Ministry of Health. Evaluation of Youth One Stop Shops. Final Report. Communio; 2009.
[13] Ministry of Health. Annual Data Explorer 2019/20: New Zealand Health Survey [Data File]. [cited 2020 February 11]. Available from: https://minhealthnz.shinyapps.io/nz-health-survey-2019-20-annual-data-explorer/
[14] Peiris-John R, Farrant B, Fleming T, et al. Youth19 Rangatahi Smart Survey. Initial findings: access to health services. Youth19 Research Group. The University of Auckland and Victoria University of Wellington, New Zealand; 2020.
[15] Roberts J, Sanci L, Haller D. Global adolescent health: is there a role for general practice? Br J Gen Pract. 2012; 62 608–10.
| Global adolescent health: is there a role for general practice?Crossref | GoogleScholarGoogle Scholar | 23211175PubMed |
[16] Turner L, Spencer L, Chang J, et al. Young people have their say: what makes a youth-friendly general practice? Aust Fam Physician. 2017; 46 70–4.
| 28189137PubMed |
[17] Hutton A, Jackson N. The voice of the adolescent: perceptions of general practice and accessing other health care services. Neonatal Paediatr Child Health Nurs. 2014; 17 10–5.
[18] Muir K, Powell A, McDermott S. ‘They don’t treat you like a virus’: youth‐friendly lessons from the Australian National Youth Mental Health Foundation. Health Soc Care Community. 2012; 20 181–9.
| ‘They don’t treat you like a virus’: youth‐friendly lessons from the Australian National Youth Mental Health Foundation.Crossref | GoogleScholarGoogle Scholar | 21929697PubMed |
[19] Braun V, Clark V. One size fits all? what counts as quality practice in (reflexive) thematic analysis? Qual Res Psychol. 2020; 1–25.
| One size fits all? what counts as quality practice in (reflexive) thematic analysis?Crossref | GoogleScholarGoogle Scholar |
[20] Abell J, Locke A, Condor S, et al. Trying similarity, doing difference: the role of interviewer self-disclosure in interview talk with young people. Qual Res J. 2006; 6 221–44.
| Trying similarity, doing difference: the role of interviewer self-disclosure in interview talk with young people.Crossref | GoogleScholarGoogle Scholar |
[21] Alderson P, Morrow V. The ethics of research with children and young people: a practical handbook. Thousand Oaks, CA: Sage; 2020.
[22] Crabtree B, Miller W. Doing Qualitative Research (2nd edn). Thousand Oaks, CA: Sage; 1999.
[23] Denny S, Farrant B, Cosgriff J, et al. Forgone health care among secondary school students in New Zealand. J Prim Health Care. 2013; 5 11–8.
| Forgone health care among secondary school students in New Zealand.Crossref | GoogleScholarGoogle Scholar | 23457690PubMed |
[24] Health Quality and Safety Commission. New data shows cost as the main barrier to accessing health services. Atlas of Variation. Health Service Access. Health Quality and Safety Commission, New Zealand Government; 2019. [cited 2021 February 15]. Available from: https://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/news-and-events/news/3786/
[25] Mathias K. Youth-specific primary health care: access, utilisation and health outcomes. New Zealand Health Technology Assessment, Department of Public Health and General Practice Christchurch School of Medicine Christchurch, NZ; 2002.
[26] van Delden A. Attendance up but Hawke's Bay teens still avoiding GP care. NZ Doctor. 2018;
[27] Ambresin A-E, Bennett K, Patton GC, et al. Assessment of youth-friendly health care: a systematic review of indicators drawn from young people’s perspectives. J Adolesc Health. 2013; 52 670–81.
| Assessment of youth-friendly health care: a systematic review of indicators drawn from young people’s perspectives.Crossref | GoogleScholarGoogle Scholar | 23701887PubMed |
[28] Farrant B, Watson PD. Health care delivery: perspectives of young people with chronic illness and their parents. J Paediatr Child Health. 2004; 40 175–9.
| Health care delivery: perspectives of young people with chronic illness and their parents.Crossref | GoogleScholarGoogle Scholar | 15009544PubMed |
[29] Kennedy EC, Bulu S, Harris J, et al. “Be kind to young people so they feel at home”: a qualitative study of adolescents’ and service providers’ perceptions of youth-friendly sexual and reproductive health services in Vanuatu. BMC Health Serv Res. 2013; 13 455
| “Be kind to young people so they feel at home”: a qualitative study of adolescents’ and service providers’ perceptions of youth-friendly sexual and reproductive health services in Vanuatu.Crossref | GoogleScholarGoogle Scholar | 24176059PubMed |
[30] Pace CA, Gergen-Barnett K, Veidis A, et al. Warm handoffs and attendance at initial integrated behavioral health appointments. Ann Fam Med. 2018; 16 346–8.
| Warm handoffs and attendance at initial integrated behavioral health appointments.Crossref | GoogleScholarGoogle Scholar | 29987084PubMed |
[31] Leavey G, Rothi D, Paul R. Trust, autonomy and relationships: the help-seeking preferences of young people in secondary level schools in London (UK). J Adolesc. 2011; 34 685–93.
| Trust, autonomy and relationships: the help-seeking preferences of young people in secondary level schools in London (UK).Crossref | GoogleScholarGoogle Scholar | 20952053PubMed |
[32] Neuwelt PM, Kearns RA, Browne AJ. The place of receptionists in access to primary care: challenges in the space between community and consultation. Soc Sci Med. 2015; 133 287–95.
| The place of receptionists in access to primary care: challenges in the space between community and consultation.Crossref | GoogleScholarGoogle Scholar | 25455478PubMed |
[33] Hetrick SE, Bailey AP, Smith KE, et al. Integrated (one-stop shop) youth health care: best available evidence and future directions. Med J Aust. 2017; 207 S5–18.
| Integrated (one-stop shop) youth health care: best available evidence and future directions.Crossref | GoogleScholarGoogle Scholar | 29129182PubMed |
[34] Ministry of Health. Services to improve funding. [cited 2021 February 14]. Available from: https://www.health.govt.nz/our-work/primary-health-care/primary-health-care-subsidies-and-services/services-improve-access
[35] Goodyear-Smith F, Ashton T. New Zealand health system: universalism struggles with persisting inequities. Lancet. 2019; 394 432–42.
| New Zealand health system: universalism struggles with persisting inequities.Crossref | GoogleScholarGoogle Scholar | 31379334PubMed |
[36] Haller DM, Sanci LA, Patton GC, Sawyer SM. Toward youth friendly services: a survey of young people in primary care. J Gen Intern Med. 2007; 22 775–81.
| Toward youth friendly services: a survey of young people in primary care.Crossref | GoogleScholarGoogle Scholar | 17380370PubMed |
[37] Carlisle J, Shickle D, Cork M, McDonagh A. Concerns over confidentiality may deter adolescents from consulting their doctors. A qualitative exploration. J Med Ethics. 2006; 32 133–7.
| Concerns over confidentiality may deter adolescents from consulting their doctors. A qualitative exploration.Crossref | GoogleScholarGoogle Scholar | 16507655PubMed |
[38] Larcher V. Consent, competence, and confidentiality. BMJ. 2005; 330 353–6.
| Consent, competence, and confidentiality.Crossref | GoogleScholarGoogle Scholar | 15705696PubMed |
[39] McKee MD, Rubin SE, Campos G, O’Sullivan LF. Challenges of providing confidential care to adolescents in urban primary care: clinician perspectives. Ann Fam Med. 2011; 9 37–43.
| Challenges of providing confidential care to adolescents in urban primary care: clinician perspectives.Crossref | GoogleScholarGoogle Scholar | 21242559PubMed |
[40] Pérez-Cárceles MD, Pereniguez JE, Osuna E, et al. Primary care confidentiality for Spanish adolescents: fact or fiction? J Med Ethics. 2006; 32 329–34.
| Primary care confidentiality for Spanish adolescents: fact or fiction?Crossref | GoogleScholarGoogle Scholar | 16731730PubMed |
[41] Imlach F, McKinlay E, Middleton L, et al. Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences. BMC Fam Pract. 2020; 21 269
| Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences.Crossref | GoogleScholarGoogle Scholar | 33308161PubMed |
[42] Wilkinson S, Wilkinson C. Researching drinking “with” young people: a palette of methods. Drugs Alcohol Today 2018; 18 6–16.
| Researching drinking “with” young people: a palette of methods.Crossref | GoogleScholarGoogle Scholar |
[43] Mawer C, Arona T, Meachen R, White D. A socio-demographic snapshot of Porirua. IDC (Imaging Decolonised Cities), Victoria University of Wellington; 2017. [cited 2020 November 11]. Available from: http://www.idcities.co.nz/resources/Porirua%20Socio%20Demographic%20Snapshot.pdf
[44] Porirua Union and Community Health Service. Annual Report. 2016/2017. Porirua: Porirua Union Community Health Service; 2017.
