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Adolescent Health Services: Missing Opportunities
and much of that work is based on surveys. Nonetheless, the committee selected some examples that highlight adolescent, parent, and practitioner perspectives.
It is important for the design and delivery of adolescent health services to appeal to adolescents and be responsive to their needs and concerns. In that spirit, the committee included questions in an online Harris Interactive poll aimed at understanding the health perspectives and interests of adolescents themselves. Nearly 1,200 adolescents responded to questions about their access to medical services, barriers to receiving care, communication about health services, the extent to which their parents or other adults or peers are involved in helping them obtain health services, their interest in using technology for health information and health reminders, and their perspective on how health services could be more helpful to them. Respondents reported that their parents are quite often involved in their health care and that they view this involvement positively. The majority of respondents indicated that they experience no access barriers to health services. When barriers were reported, cost and scheduling were cited most frequently, along with a lack of insurance. Respondents frequently mentioned having access to affordable, convenient, and high-quality dental care as what they would most like to change about health services to make them more helpful. Although confidentiality appeared to be of low concern, 10 percent of respondents worry that their parents will learn information they do not want their parents to have. (Privacy and confidentiality issues are discussed further below.) About 20 percent of respondents are extremely or very interested in using technology (e.g., mobile phones, the Internet) to obtain health information.
Differences in adolescent perspectives may be attributable to certain demographic variables. Family values and structures, for instance, may play a role in the health behavior and attitudes of adolescents. A study of urban adolescent males found that family circumstances influenced attitudes toward sexual behavior. Young male adolescents who were raised by a single parent with no father present or had a mother who was a teenage parent reported little concern about sexual responsibility. By contrast, urban adolescent males with two parents in the home or father-figure relationships expressed concern about their sexual health and the possibility of becoming a teenage father (Gohel, Diamond, and Chambers, 1997).
Gender may also have an impact on adolescent perspectives. In a study conducted by Pleck and O’Donnell (2001), male adolescents reported more risky health behavior than did female adolescents. Another study found that while 87 percent of healthy adolescents were satisfied with the general