EFFECTIVE ORGANIZATION OF ADOLESCENT HEALTH SERVICES

点击翻译按钮获取中文摘要

DESCRIPTION: This application proposes to conduct two surveys to better understand how the organization and availability of adolescent health services affects adolescents' access to health services. Ultimately the investigators would like to assess the importance and effectiveness of various strategies for organizing adolescent health services. The investigators are using an environment-systems-services-outcomes evaluation model, based on Starfield's primary care health services domains and Aday and Andersen's framework for studying access. In response to the prior review recommendation to reduce the scope of the research project, the investigators chose to postpone data collection related to surveys of adolescents thereby eliminating it from this study. Hence they will not be examining the adolescent outcomes dimension of their model. For providers' outcomes they will measure perceived program accessibility, quality, satisfaction, and rates of reported service use. The study proposes to test two hypotheses: 1) greater availability of comprehensive services is associated with better accessibility, coordination, and better quality of care among all available service providers in a geographic area, and 2) the type of service delivery organization (i.e., school-based clinic, hospital, etc.) is the most important predictor of the provider's comprehensiveness, coordination, and quality, but this relationship is significantly modified by mutable organizational factors, (e.g., programs' interorganizational relationships.)