The Essential Elements of Adolescent-friendly Care in School-based Health Centers: A Mixed Methods Study of the Perspectives of Nurse Practitioners and Adolescents

Abstract

PurposeIn this study we identified the essential elements of adolescent-friendly care in school-based health centers (SBHCs) from the perspectives of the nurse practitioners (NPs) providing care to adolescents and the adolescents, as the consumers of these services. Design and methodsComplex adaptive systems provided the philosophical and theoretical foundation for this study. An explanatory sequential mixed methods study was conducted. A Delphi technique (strand one) was conducted with an expert panel of NPs (N = 21) to identify the essential elements of adolescent-friendly care in SBHCs. The second strand, a focus group study with adolescents (N = 30), elaborated on the Delphi results. Data from the two strands were then mixed. ResultsThis study generated expert opinion regarding the essential elements of adolescent-friendly health care in SBHCs. After four Delphi rounds, consensus was reached on 98-items (49% of the original 200; consensus level of 0.75). The results clustered into 6 essential elements: Confidentiality/Privacy (n = 8; 8.2%), Accessibility, (n = 15; 15.3%), Clinician/Staff (n = 51; 52%), SBHC Clinical Services (n = 12; 12.2%), SBHC Environment (n = 4; 4.1%), and Relationship between the School and SBHC (n = 8; 8.2%). The adolescent focus groups confirmed the essential elements identified in the Delphi and added two overarching themes: Comfortable and Trusted Relationship. ConclusionsThese findings contribute to a greater understanding of essential characteristics needed in adolescent friendly care. Practice implicationsSBHCs, as an important community resource for addressing the health care needs of adolescents, should incorporate these characteristics.