Texas A&M University, College Station, TX, USA.
Integral Global, Tucker, GA, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241234586. doi: 10.1177/21501319241234586.
Adolescent access to quality healthcare is key to prevention and early intervention for health risk behaviors. This paper provides a healthcare provider perspective on barriers and facilitators to youth accessing care.
Five focus groups were conducted from November to December 2020 with providers from a variety of healthcare settings. Participants were asked to describe their respective adolescent patient populations, adolescent-specific health concerns, and organizational accommodations specific for youth services. Transcripts were analyzed using Inductive Thematic Analysis and themes were grouped using a social-ecological framework.
At an individual level, providers noted that an adolescent's knowledge and ability to navigate services varied greatly across settings. Providers identified provider trust and parent/guardian support as key interpersonal factors that support adolescents' access to services. Organizational factors included bureaucratic barriers and the clinic's reputation among youth. Community factors centered on mistrust within healthcare systems and stigmatization of seeking certain types of services. Participants also described how state-level policies influence parent/guardian consent requirements, which can limit adolescents' access to care.
Adolescent access to and utilization of healthcare in the United States is a complex problem requiring systems-level change. Healthcare organizations and providers have the opportunity and capacity to positively influence adolescents' healthcare access and experiences, however a lack of standardized, clinic-level priorities and guidelines can limit adolescent-centered care.
青少年获得高质量的医疗保健服务对于预防和早期干预健康风险行为至关重要。本文从医疗服务提供者的角度出发，探讨了青少年获得医疗服务的障碍和促进因素。
2020 年 11 月至 12 月期间，我们与来自不同医疗保健机构的提供者进行了 5 次焦点小组讨论。参与者被要求描述他们各自的青少年患者群体、青少年特有的健康问题以及专门针对青年服务的组织适应措施。使用归纳主题分析对转录本进行分析，并使用社会生态框架对主题进行分组。
在个人层面上，提供者指出，青少年对服务的了解和利用能力在不同环境中存在很大差异。提供者认为，提供者的信任和家长/监护人的支持是支持青少年获得服务的关键人际因素。组织因素包括官僚障碍和诊所在年轻人中的声誉。社区因素主要集中在医疗保健系统内的不信任和对某些类型服务的污名化上。参与者还描述了州级政策如何影响家长/监护人的同意要求，这可能会限制青少年获得护理的机会。
美国青少年获得和利用医疗保健服务是一个复杂的问题，需要进行系统层面的变革。医疗保健组织和提供者有机会和能力积极影响青少年的医疗保健获取和体验，但缺乏标准化的、诊所层面的优先事项和指导方针可能会限制以青少年为中心的护理。
