How do primary healthcare and social services enable young people’s participation?

Abstract

Background and purpose: Participation is a crucial factor in primary healthcare and social services, enabling clients to maintain their own health and well-being. However, adolescents’ participation in service provision may be compromised because they are often not understood or heard as equal clients in encounters with primary services. The aim of this study was to describe 15- to 17-year-olds’ experiences of participation in primary healthcare and social services’ settings. Methods: Data were collected through group interviews ( N = 27) with 106 participants drawn from upper comprehensive schools, upper secondary schools and youth centres in the region of a city in northern Savonia, Finland. Data were analysed by qualitative content analysis, using typology technique. Results: Four levels of realisation of participation were identified (inviting, allowing, avoiding and excluding), each with distinctive sets of atmospheres, interactions and experiences of the service received. According to the interviewees, the atmosphere varied from caring to cold, interactions from empowering to discouraging and experience of services from meaningful to threatening. Conclusion: Young people’s participation in health services can be strengthened by creating a positive atmosphere, providing possibilities to be heard and ensuring that support corresponds with individual needs. The indications of aspects of atmosphere, interactions, and clients’ experience that promote or deter adolescents’ participation may assist efforts to improve health and social services by signposting ways to raise realization of participation to the ‘inviting’ level. Study findings are useful for evaluating, strengthening and raising awareness of the importance of participation in all aspects of health promotion (practice, management and education).