The Essential Elements of Adolescent-friendly Care in School-based Health Centers: A Mixed Methods Study of the Perspectives of Nurse Practitioners and Adolescents

In this study we identified the essential elements of adolescent-friendly care in school-based health centers (SBHCs) from the perspectives of the nurse practitioners (NPs) providing care to adolescents and the adolescents, as the consumers of these services. Complex adaptive systems provided the ph...

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Bibliographic Details
Published in:	Journal of pediatric nursing 2019-07, Vol.47, p.7-17
Main Authors:	Daley, Alison Moriarty, Polifroni, E. Carol, Sadler, Lois S.
Format:	Article
Language:	eng
Subjects:	Adolescent Adolescent Health Services - organization & administration Attitude of Health Personnel Confidentiality Delphi Technique Female Focus Groups Health Services Accessibility Health Services Needs and Demand Humans Male Mixed methods Nurse practitioner Nurse Practitioners - psychology Nurse-Patient Relations Nursing Perspectives Privacy School Health Services - organization & administration School-based health center Students - psychology United States
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Summary:	In this study we identified the essential elements of adolescent-friendly care in school-based health centers (SBHCs) from the perspectives of the nurse practitioners (NPs) providing care to adolescents and the adolescents, as the consumers of these services. Complex adaptive systems provided the philosophical and theoretical foundation for this study. An explanatory sequential mixed methods study was conducted. A Delphi technique (strand one) was conducted with an expert panel of NPs (N = 21) to identify the essential elements of adolescent-friendly care in SBHCs. The second strand, a focus group study with adolescents (N = 30), elaborated on the Delphi results. Data from the two strands were then mixed. This study generated expert opinion regarding the essential elements of adolescent-friendly health care in SBHCs. After four Delphi rounds, consensus was reached on 98-items (49% of the original 200; consensus level of 0.75). The results clustered into 6 essential elements: Confidentiality/Privacy (n = 8; 8.2%), Accessibility, (n = 15; 15.3%), Clinician/Staff (n = 51; 52%), SBHC Clinical Services (n = 12; 12.2%), SBHC Environment (n = 4; 4.1%), and Relationship between the School and SBHC (n = 8; 8.2%). The adolescent focus groups confirmed the essential elements identified in the Delphi and added two overarching themes: Comfortable and Trusted Relationship. These findings contribute to a greater understanding of essential characteristics needed in adolescent friendly care. SBHCs, as an important community resource for addressing the health care needs of adolescents, should incorporate these characteristics. •School-based health centers support the World Health Organization’s criteria for adolescent-friendly health care services•Confidentiality and privacy were found to be most important to adolescents receiving care in school-based health centers•Feeling comfortable and a trusted relationship with a provider impacts adolescents’ willingness to engage in health services•Mental health and reproductive services were identified as essential services for adolescents•School-based health centers are an important community resource for addressing the health care needs of adolescents
ISSN:	0882-5963 1532-8449