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Adolescent Health Services: Missing Opportunities
Features of Quality Adolescent Health Services
The committee was asked to consider what features constitute high-quality adolescent health services. The provision of such services is dependent on successful interactions between adolescents and health service settings and systems, and achieving this requires a multifaceted approach. The committee was guided by two basic frameworks in its data collection, review of the evidence, and deliberations on various dimensions of adolescent health status and health services. The first of these frameworks focuses on behavioral and contextual characteristics that influence how adolescents interact with the health system, and the second on the objectives of adolescent health services. Neither framework alone is sufficient to explain significant variations in adolescent health outcomes; rather, they complement each other and, in tandem, provide a more complete picture of the features of the health system that should be improved in order to provide adolescents high-quality care and thus help to improve their health status.
Framework 1: Behavioral and Contextual Characteristics
Certain sets of behavioral and contextual characteristics, listed below, matter for adolescents in the ways they approach and interact with health care services, providers, and settings. When these characteristics are addressed in the design of health services for adolescents, those services can offer high-quality care that is particularly attuned to the needs of this age group. These characteristics helped frame the chapters of this report and, where relevant and supported by the evidence, are reflected in the committee’s recommendations.
Development matters. Adolescence is a period of significant and dramatic change spanning the physical, biological, social, and psychological transitions from childhood to young adulthood. This dynamic state influences both the health of young people and the health services they require.
Timing matters. Adolescence is a critical time for health promotion. Many health problems and much of the risky behavior that underlies later health problems begin during adolescence. Prevention, early intervention, and timely treatment improve health status for adolescents and prepare them for healthy adulthood; such services also decrease the incidence of many chronic diseases in adulthood.
Context matters. Social context and such factors as income, geography, and cultural norms and values can profoundly affect the health of adolescents and the health services they receive.