Barriers to Health Services for Adolescents. Don Langille, MD Professor Department of Community Health & Epidemiology. Barriers to Health Services for Adolescents. Most adolescent primary care delivered by physicians.
Don Langille, MD
Department of Community Health & Epidemiology
Concerns about confidentiality can cause adolescents to:
A US study published (Ford et al, JAMA, 1999) found that of students who had forgone needed health care 11.5% (95% CI 10.0-13.0) had done so because they didn’t want their parents to know.
1997 Commonwealth Fund Survey of Health of Adolescent Girls, a nationally representative school-based survey of 6748 girls in grades 5-12(Klein, JAH, 1999)
Reddy et al (JAMA, 2002) asked 1118 females aged <18 at Wisconsin Planned Parenthood clinics about the impact of parent notification.
Jones et al (JAMA, 2005), using a sample of 80 publicly funded FP clinic in the US, asked women <18 (n=1526) seeking sexual health services how they would react if parent notification were mandatory:
Student survey in northern Nova Scotia (Langille, 2001). Proportions of sexually active students (n=650) not having discussed sexual health with a physician due to:
Embarrassment 37 56
Might tell parents 23 54
Lack of respect 21 41
Student survey in Cape Breton, Nova Scotia (Langille, 2007). Proportions of sexually active students (both sexes, n=379) giving reasons for first attendance:
More comfortable at SBHC 63
Confidentiality maintained 63
Appropriate info available 60
Nurse non-judgmental 55
What strategies can be used to assure that issues of confidentiality are fully addressed at SBHCs?