Toward Youth Friendly Services: A Survey of Young
People in Primary Care
Dagmar M. Haller, MD, PhD
, Lena A. Sanci, MBBS, PhD
, George C. Patton, MBBS, PhD
and Susan M. Sawyer, MBBS, MD
, Centre for Adolescent Health, Murdoch Children’s Institute at the Royal Children’s Hospital Melbourne, Australia;
Department of General
Practice, The University of Melbourne Melbourne, Australia;
Department of Paediatrics, The University of Melbourne Melbourne, Australia;
Department of Community and Primary Care Medicine, Geneva University Hospitals, Rue Micheli-du-Crest 24, 1211 Geneva 14, Switzerland.
BACKGROUND: The World Health Organization
encourages the development of youth friendly services,
yet little is known on how youth currently present in
OBJECTIVE: To describe the perspectives, expecta-
tions, and service receipt of young people presenting to
family doctors to inform the development of youth
DESIGN: Cross-sectional survey.
PARTICIPANTS AND MEASUREMENTS: Consecutive
young people attending 26 randomly selected practices
were recruited in the waiting rooms. Standardized
instruments were used to interview them before their
RESULTS: Of 501 young people who were approached,
450 participated (91% participation rate). Most had
respiratory (26%) or dermatological complaints (18%).
When asked to assess their health status, 59% per-
ceived they had neither a physical nor a mental illness.
However, 43% stated they had fears about their health
problem and 1 in 5 feared it could be life-threatening.
Although only 10% presented with psychological com-
plaints, 24% perceived they currently had a mental
illness. The most common expectations were treatment
(50%) and good communication (42%). Most youth were
prescribed medication (60%), but 40% of those who
received a prescription had not expected to receive a
treatment. A follow-up appointment was offered to 57%
CONCLUSIONS: This study identifies a gap between
young people’s perception of illness and their presenta-
tions to family doctors. It also highlights unexpected
fears, and a mismatch between expectations and service
receipt. These findings have implications for family
medicine training and for clinical practice. They should
inform the development of youth friendly services.
KEY WORDS: family practice; adolescent health services;
health knowledge; attitudes; practice.
© 2007 Society of General Internal Medicine 2007;22:775–781
The World Health Organization (WHO) recently emphasized the
need to develop youth-friendly health services to improve the
care provided to young people throughout the world.
countries with established economies, psychosocial problems
represent the greatest burden of disease for young people
including mental disorders; tobacco, alcohol, and other sub-
stance use; accidents and injury; sexually transmitted dis-
eases; and unwanted pregnancies.
Youth (defined by WHO
as young people between 15 and 24 years) are in particular
need of developmentally appropriate services to address this
largely preventable disease burden as many do not receive
professional help for the problems that affect them.
Most young people visit a family doctor at least once a
. Hence, family doctors are ideally placed to identify
and respond to the common psychosocial burdens of youth.
Studies indicate that despite the burden of disease attribut-
able to mental and behavioral disorders, the majority of
consultations to family doctors are for somatic health pro-
blems (respiratory and dermatological).
4, 12, 13
of them would welcome a discussion on these themes, few
receive counseling about health-related behaviors in the
In the US, about 8% of all ambulatory care
encounters (specialist and primary care) are with patients in
the age group 15 to 24 years.
In Australia, approximately
10% of primary care encounters are with youth, yet little is
known about the characteristics of this group of primary care
To date, much of the research on the relationship
between youth and primary care has focused on the barriers
young people encounter to accessing care.
4, 11, 19, 20
we know little of why young people who do go to see family
doctors actually present, what they expect from the consulta-
tion, and the types of services provided to them.
baseline knowledge is important for highlighting ways in which
primary care can become more responsive to the needs of
youth. The aim of the present study was to describe this profile
of youth visiting family doctors.
This study was presented as an abstract at the 2006 General Practice
and Primary Care Research Conference in Perth, Australia, in July 2006.
Received September 12, 2006
Revised March 1, 2007
Accepted March 13, 2007
Published online March 23, 2007