FACTORS AFFECTING THE DECISION TO SEEK HEALTH-CARE - THE VOICE OF ADOLESCENTS

Objective. To learn from teenagers why they do, or do not, seek preven tive health care. Methods. A teen-centered methodology utilized focus groups, nominal group technique sessions, and surveys to allow adolesc ents to generate, prioritize, and explain their own responses. This ar ticle reports the qualitative explanations offered by youths in focus groups. In 21 groups, teenagers commented on the 15 factors that ninth graders in the School District of Philadelphia had determined most in fluenced their decision to seek care. Transcriptions were reviewed for consistent themes. Direct quotations are presented here to be represe ntative of those themes. Results. Two key points emerged. First, adole scents are more concerned about provider characteristics than site or system characteristics. Second, they worry deeply about disease transm ission in the health care setting. Teenagers suggest some simple steps that may produce significant inroads toward developing an effective w orking relationship with them. A few examples include: to alleviate an xiety of disease transmission, providers should wash hands and remove instruments from sterile packaging in front of patients; to reassure t eenagers of competence, providers should keep diplomas and certificate s displayed; and to alleviate perceptions of racism, sites should post signs that clearly explain why patients are sometimes seen out of ord er. Conclusions. Adolescents know what draws them to services and what offends them. This study documents, in the words of youths, the facto rs contributing to their decisions to seek care. The results allow hea lth professionals who care for adolescents to consider what they do we ll and where change may be needed.