Abstract
BackgroundThe purpose of this paper is to propose a protocol for researching the impact of rural youth health service strategies on health care access. There has been no published comprehensive assessment of the effectiveness of youth health strategies in rural areas, and there is no clearly articulated model of how such assessments might be conducted. The protocol described here aims to gather information to; i) Assess rural youth access to health care according to their needs, ii) Identify and understand the strategies developed in rural areas to promote youth access to health care, and iii) Propose actions for further improvement. The protocol is described with particular reference to research being undertaken in the four northernmost counties of Sweden, which contain a widely dispersed and diverse youth population.MethodsThe protocol proposes qualitative and quantitative methodologies sequentially in four phases. First, to map youth access to health care according to their health care needs, including assessing horizontal equity (equal use of health care for equivalent health needs,) and vertical equity (people with greater health needs should receive more health care than those with lesser needs). Second, a multiple case study design investigates strategies developed across the region (youth clinics, internet applications, public health programs) to improve youth access to health care. Third, qualitative comparative analysis of the 24 rural municipalities in the region identifies the best combination of conditions leading to high youth access to health care. Fourth, a concept mapping study involving rural stakeholders, care providers and youth provides recommended actions to improve rural youth access to health care.DiscussionThe implementation of this research protocol will contribute to 1) generating knowledge that could contribute to strengthening rural youth access to health care, as well as to 2) advancing the application of mixed methods to explore access to health care.
Highlights
The purpose of this paper is to propose a protocol for researching the impact of rural youth health service strategies on health care access
This study aims to; i) Assess rural youth access to health care according to their needs, ii) Identify and understand the strategies developed in rural areas to promote youth access to health care, and iii) Propose actions for further improvement
In this paper we describe a protocol that uses mixedmethods to analyse rural youth access to health care according to their needs, and propose actions for further improvement
Summary
The purpose of this paper is to propose a protocol for researching the impact of rural youth health service strategies on health care access. The protocol described here aims to gather information to; i) Assess rural youth access to health care according to their needs, ii) Identify and understand the strategies developed in rural areas to promote youth access to health care, and iii) Propose actions for further improvement. This research protocol will lay the foundation for strengthening youth health care services in rural areas of northern Sweden by mapping youth access to health care services and critically evaluating strategies used to enhance access. While it is well known that access to health care services continues to be a challenge for populations living in rural areas in Sweden (and elsewhere), existing research has focused mainly on the general population or on elderly groups, overlooking the situation of youth. Poor access to health care services for young people may result in both short-term harm and long-term disengagement with the services, causing poorer population health outcomes and higher overall costs to the health care system [9]
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