Health services can be cool: partnership with adolescents in primary care.
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Young people's health is giving rise to increasing concern. However, despite recent government emphasis on patient involvement and partnership, little discussion has occurred concerning how this may be achieved with younger age groups in primary care. Here we outline issues relating to adolescents' health and characteristics of current provision. These are considered in the context of innovative services that have incorporated adolescents' views. Finally, we discuss the challenge of establishing a partnership with adolescents and propose strategies for achieving this. (+info)
Child and adolescent mental health service use. HoNOSCA as an outcome measure.
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BACKGROUND: HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents) is a recently developed measure of outcome for use in child and adolescent mental health services (CAMHS). AIMS: To examine HoNOSCA's sensitivity to change, convergent validity and clinical usefulness. METHOD: Prospective study of new CAMHS attenders. Questionnaires completed by clinicians, parents and referrers at initial assessment and after 6 months. RESULTS: Follow-up HoNOSCAs on 203 children indicated statistically significant change. There were significant associations between change in HoNOSCA scores, changes in other clinician- and parent-rated scales (r = 0.51 to 0.32) and in global outcome ratings by referrers, parents and clinicians. Intraclass correlation coefficients for the summated HoNOSCA scores were high. HoNOSCA change was positively correlated with initial HoNOSCA score (r = 0.46, P < 0.001) and it was linked to psychiatric diagnosis. CONCLUSIONS: HoNOSCA is a sensitive, valid measure of change among CAMHS attenders. (+info)
Young teenagers' attitudes towards general practitioners and their provision of sexual health care.
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BACKGROUND: Pregnancy rates in under-16-year old teenagers and sexual risk-taking are both increasing. Ensuring that teenagers access health care--particularly sexual health care--appropriately is problematic. AIM: To find out the opinions and attitudes of 13- to 15-year-old teenagers towards general practice-based sexual health care services. METHOD: A quantitative survey, using a questionnaire completed during school hours. RESULTS: One thousand and forty five children aged 13 to 15 years completed questionnaires. The majority (709 [68%]) were aware of the sexual health services offered by general practitioners (GPs), and 786 (75%) were positive about being given helpful advice at a consultation. However, 567 (54%) teenagers believed they had to be over 16 years old to access sexual health services and 604 (58%) were concerned about their confidentiality not being preserved by their GP. They were also concerned about GPs not having the time or skills to deal with their problems (314 [30%]). CONCLUSIONS: This study suggests that work is needed to improve teenagers' access to, and use of, primary care sexual health services. In particular, identifying strategies that improve teenagers' awareness of services and general practitioners' approaches towards teenagers are priorities. (+info)
Teenagers educating teenagers about reproductive health and their rights to confidential care.(20/453)
Prevention of unhealthy behaviour by youth health care in The Netherlands.
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BACKGROUND: In this study the effect is assessed of (repeated) well-care visits and freely accessible consultation hours at secondary schools on the prevalence of adolescent health-compromising behaviour and later obesity. METHODS: An ecological case-referent study design was used with data from the Netherlands Bureau of Statistics, the Ministry of Defence, the 1992 High-School Student Study, all youth health care departments in The Netherlands and relevant census. Data from the High-School Student Study included 4,569 students aged 12-18 years, of whom 4,167 had answered all questions on health-compromising behaviour and eating habits. The data from the Ministry of Defence included 1,004 cases with a body mass index greater than 27 of a total of 12 251 male conscripts. The census of 18- and 19-year-old males in the regions of the relevant youth health care departments served as referents. RESULTS: Except for the use of alcohol, the effect of more well-care visits was in all cases negative, and for the use of tobacco even significantly so [odds ratio (OR) = 1.15, 95 per cent confidence interval (CI) = 1.01-1.33]. The availability of open consultation hours had an adverse effect on use of alcohol (OR = 1.29, 95 per cent CI = 1.11-1.50). The OR for obesity in male conscripts showed an adverse effect of a greater number of well-care visits (OR = 2.46, 95 per cent Cl = 1.74-3.46) and the availability of open consultation hours (OR = 1.97, 95 per cent CI = 1.72-2.25). CONCLUSIONS: This study does not support the hypothesis that, at a population level, preventive activities of youth health care departments such as (more) frequent well-care visits or offering open consultation hours at secondary schools, have a beneficial effect on prevention of health-compromising behaviour or obesity. (+info)
The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania.
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We evaluated the effect of weekly doses of 400 mg of ferrous sulphate for 4 months on the iron status of adolescent girls in a controlled trial in Tanga, Tanzania. Supplementation led to a significantly greater increase in serum ferritin compared with the control group (+ 15.6 microg/l vs. 8.6 microg/l) (P = 0.002) but there was no significant difference in change in haemoglobin. Children given iron showed a significantly greater weight gain than controls (+ 2.4 kg vs. + 1.4 kg) (P = 0.03). Weekly iron supplementation may be an effective means of increasing iron stores and growth in children vulnerable to iron deficiency. (+info)
Health of teenagers in residential care: comparison of data held by care staff with data in community child health records.
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AIM: To identify whether there are gaps in information available to care staff about the health related needs of one group of teenagers in residential care which could be addressed by reviewing the community child health records. METHODS: Data were collected on the residents of a children's home during a three month period, comparing information from children's home records with information from community child health records. RESULTS: Data were collected from children's home records for 36 residents and child health records obtained for 29. Child health records provided the only information on 53% of child protection registrations and 17.5% of statements of special educational needs. Most information on birth history, developmental and early medical history, immunisations, growth, hearing, and colour vision came from the child health records. Immunisation uptake was below the national average, and particularly poor for BCG and school leaver tetanus, low dose diphtheria, and polio boosters. Emotional and behavioural problems were present in 100% of the residents and this information was known to the home. Poor use of "Looking After Children" records was identified, and there was a paucity of information in the home records and child health records about results of annual looked after medical examinations. CONCLUSION: Important information about the health needs of looked after teenagers was not known to the children's home staff. Community paediatricians should be proactive in identifying and addressing these needs. (+info)
Back to school: a health care strategy for youth.
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School-based health centers (SBHCs) are a policy innovation designed to increase health care access among youth. The centers offer primary and acute care, often to underserved populations. We describe SBHCs, trace their history, and analyze the three great political challenges they face: moral opposition triggered by concern about reproductive health services in schools; funding in a managed care era; and partisan state politics. We show how the centers have been meeting these challenges. Finally, we consider the prospect of this innovation going to scale across the nation. (+info)