Global adolescent health: is there a role for general practice?

Roberts, Jennifer; Sanci, Lena; Haller, Dagmar M.

doi:10.3399/bjgp12x658458

Cited by 18 publications

(14 citation statements)

References 8 publications

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“…In contrast to mainstream general practice, the YOSS wraparound model demonstrably reduces many of the barriers to health and social service utilisation associated with cost, multiple agency‐involvement and fragmented services. However this model of care is not needed for everyone; mainstream general practice, if as youth‐friendly as possible, can be a very satisfactory place for the delivery of primary care to young people who have straightforward needs (Roberts, Sanci, & Haller, ). Nevertheless, at present, cost is often a significant barrier for young people accessing mainstream services; proposed changes in government funding policy (Ministry of Health, ) may address this in part, in future.…”

Section: Discussionmentioning

confidence: 99%

Interagency collaborative care for young people with complex needs: Front‐line staff perspectives

Morgan

Pullon

Garrett

et al. 2019

Health Soc Care Community

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Worldwide, a growing burden of health and social issues now affect young people.Interagency collaboration and the "integration" of health and social care services are advocated to address the increasingly complex needs of at-risk youth and to reduce barriers to accessing care. In New Zealand, Youth-One-Stop-Shops (YOSSs) provide integrated health and social care to young people with complex needs. Little is known about how YOSSs facilitate collaborative care. This study explored the collaboration between YOSSs and external agencies between 2015 and 2017 using a multiple case study method. This paper reports qualitative focus group and individual interview data from two of four case sites including six YOSS staff and 14 external agency staff.Results showed participants regarded collaboration as critical to the successful care of high needs young people and were positive about working together. They believed YOSSs provided effective wraparound collaborative care and actively facilitated communication between diverse agencies on behalf of young people. The main challenges participants faced when working together related to the different "world views" and cultures of agencies which can run contrary to collaborative practice.Despite this, some highly collaborative relationships were apparent and staff in the different agencies perceived YOSSs had a lead role in co-ordinating collaborative care and were genuinely valued and trusted. However without the YOSS involvement, collaboration between agencies in relation to young people was less frequent and rarely went beyond limited information exchange. Establishing and maintaining trusting interpersonal relationships with individual staff was key to successfully negotiating agency differences. The study confirms that collaboration when caring for young people with high needs is complex and challenging, yet agencies from diverse sectors value collaboration and see the YOSS integrated wraparound approach as an important model of care. K E Y W O R D S community care, complex needs, general practice, integrated care, inter-organisational working, young people How to cite this article: Morgan S, Pullon S, Garrett S, McKinlay E. Interagency collaborative care for young people with complex needs: Front-line staff perspectives. Health Soc

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Section: Discussionmentioning

confidence: 99%

Interagency collaborative care for young people with complex needs: Front‐line staff perspectives

Morgan

Pullon

Garrett

et al. 2019

Health Soc Care Community

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“…They may have poor experience of care,6 or the care given might have been unsatisfactory 3,7. The young people’s needs include issues relating to contraception, menstruation, acne, illness in the family, and arguments with parents 8. In general, although many young people report their physical problems to the health services, a large percentage of adolescents with mental health issues do not seek help 9.…”

Section: Introductionmentioning

confidence: 99%

Encouraging adolescents to contact their GP: a community-based trial

2014

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BackgroundAdolescents, especially males, often fail to see their GP.AimTo determine whether an informative letter could enhance the accessibility and utilisation of healthcare facilities and services.Design and settingA community-based trial in one town in Oslo, using a retrospective control group.MethodGPs in one town in Oslo sent a personal, informative letter at the beginning of 2008 and 2009 to individuals in their practice population who were turning 16 years of age that year. The pooled data for the same year for each surgery were collected. Retrospective data from 1990 and 1991 served as controls for the intervention groups of data collected in 2006 and 2007 respectively. An International Classification of Primary Care-2 diagnosis was given for each contact.ResultsThe proportion of adolescents in contact with a GP increased from 59% in the control group to 69% in the intervention group (P<0.001). For the males, the increase was from 54% to 72% (P<0.001). This reduced sex differences in healthcare seeking. For diagnoses mentioned in the informative letter the incidence rose from 38% in the control group to 55% in the intervention group (P<0.001). For the females, there was a non-significant increase in the proportion in contact with the GP, from 63% to 66% in control and intervention groups, respectively. The most frequent contact reasons were respiratory disorders, followed by general and unspecified complaints, skin disorders, musculoskeletal disorders, and psychological disorders. This pattern did not change because of the intervention.ConclusionAn information letter about health problems and health rights (such as the protection of the adolescent’s privacy) seems to enhance the accessibility and utilisation of GPs, as measured by contact rate, particularly for males.

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“…Adopting the internationally advocated 'life-course' approach to teaching about adolescence requires all educators to review their curricula and better prepare clinicians to promote good adolescent health. 39,40 The proposed model also invites further research which should explore adolescent perspectives on consulting with GPs who display different clinical approaches.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

GPs’ responses to adolescents presenting with psychological difficulties: a conceptual model of fixers, future planners, and collaborators

Roberts¹,

Crosland

Fulton

2014

Br J Gen Pract

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BackgroundPsychological difficulties are common in adolescents yet are not often addressed by GPs. Anxiety and uncertainty about professional practice, with a reluctance to medicalise distress, have been found among GPs. GP involvement in this clinical area has been shown to be influenced by how GPs respond to the challenges of the clinical consultation, how they view young people and their perception of their health needs, and a GP's knowledge framework. AimTo explore the relationship between the above three influences to develop an overarching conceptual model. Design and settingQualitative study based in 18 practices in the north east of England. The practices recruited included rural, urban, and mixed populations of patients predominantly living in socioeconomically disadvantaged communities. MethodTheoretical sampling was used to guide recruitment of GP participants continuing until theoretical saturation was reached. Data were analysed using the constant comparative method of grounded theory and situational analysis. ResultsIn total 19 GPs were recruited: 10 were female, the age range was 29-59 years, with a modal range of 40-49 years. Three levels of analysis were undertaken. This study presents the final stage of analysis. GP 'enactment of role' was found to be the key to explaining the relationship between the three influencing factors. Three role archetypes were supported by the data: 'fixers', 'future planners', and 'collaborators'. ConclusionThe role of GPs in managing adolescent psychological difficulties is unclear. Policy advocates a direct role but this is unsupported by education and service delivery. GPs adopt their own position along a continuum, resulting in different educational needs. Better preparation for GPs is required with exploration of new, more collaborative models of care for troubled adolescents. Keywordsadolescent psychological difficulties; GP consultation style; youth mental health.

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Global adolescent health: is there a role for general practice?

Cited by 18 publications

References 8 publications

Interagency collaborative care for young people with complex needs: Front‐line staff perspectives

Interagency collaborative care for young people with complex needs: Front‐line staff perspectives

Encouraging adolescents to contact their GP: a community-based trial

GPs’ responses to adolescents presenting with psychological difficulties: a conceptual model of fixers, future planners, and collaborators

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