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  • 101.
    Waenerlund, Anna-Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jonsson, F.
    Does youth clinics in northern Sweden offer person-centered care?2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl_3, p. 528-Article in journal (Other academic)
    Abstract [en]

    Background: It is especially important for youth that the care is person-centered, responding to the need of the individual which usually will be broader and more complex than the specific health problem they consult in the first place. That in terms of youth health care everything is connected and health care services can be an opportunity to discuss sexual & reproductive SRS issues and mental health issues. The literature show that with young people the reason for consultation can only be an excuse to come to a health care professional. To examine this issue and in an attempt to increase our understanding about youths’s experiences of visiting youth clinics in Sweden overall, the present study compared reasons for the consultation at the youth clinic to the topics attended at the consultation, and by doing so also measuring the level of person-centered care.

    Methods: Data from a cross-sectional survey sent out in September 2016 collected from twenty-two youth clinics in the four northern most counties in Sweden, was used in the present study. In total 1223 youth responded to the survey. Chi2 was used to determine significant differences.

    Results: Preliminary results shows that of the youth participating in the survey 63.9% got a balanced response to what they asked for, 27.7% were offered more than their initial asked for and 8.4% were offered less than what they asked for. Being offered more than you asked for was not depending on gender, sexual orientation or trans identification. However, on county-level there were differences, where Västernorrland offered more to 35.5%, Jämtland 28.2%, Norrbotten 22.1% and Västerbotten 21.5% of the youth.

    Conclusions: The results could be interpreted as a sign that youth clinics offers person-centered care (responding to the needs beyond the specific reason for consultations). In between county difference may be related to differences in organizational systems between counties.

    Key messages:

    • Youth clinics in northern Sweden offers person-centred care to young people, by responding to the needs beyond the specific reason for consultation.
    • The level of person centred care offered is dependent on county but not on gender or sexual orientation.
  • 102.
    Wagenius, Cecilia M.
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Norrbotten County Council, Public Health Centre, Sweden.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Gustafsson, Per E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Access for all?: Assessing vertical and horizontal inequities in healthcare utilization among young people in northern Sweden2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous studies in Sweden have detected socioeconomic inequities in access to healthcare services. However, there is limited information regarding access in younger populations. The aim of this study was to explore vertical and horizontal inequities in access to healthcare services in young adults in the north of Sweden.

    METHODS: The study used data from the Health on Equal Terms survey (age group 16-24 years, n = 2726) for the health and healthcare variables and from national registers for the sociodemographic characteristics. Self-rated healthcare utilization was measured as visits to general practitioners, youth clinics and nurses. Crude and multivariable binomial regression analysis, stratified by sex, was used to assess vertical equity, adjusting for sociodemographic characteristics, and horizontal equity, adjusting for need variables.

    RESULTS: Vertical inequity was detected for all three healthcare services (youth clinics, general practitioners and nurses), with variations for men and women. Horizontal inequities were also found for both men and women in relation to all three healthcare services.

    CONCLUSIONS: These findings suggest that both vertical and horizontal inequities in access exist for young people in northern Sweden and that the associations between sociodemographic characteristics and healthcare utilization are complex and need further investigation.

  • 103. Zulu, Joseph M.
    et al.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Kinsman, John
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sandøy, Ingvild Fossgard
    Blystad, Astrid
    Mulubwa, Chama
    Makasa, Mpundu C.
    Michelo, Charles
    Musonda, Patrick
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Community based interventions for strengthening adolescent sexual reproductive health and rights: how can they be integrated and sustained? A realist evaluation protocol from Zambia2018In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 15, article id 145Article in journal (Refereed)
    Abstract [en]

    Background: Research that explores how community-based interventions for strengthening adolescent sexual reproductive health and rights (SRHR) can be integrated and sustained in community health systems, is, to the best of our knowledge, very scarce, if not absent. It is important to document mechanisms that shape integration process in order to improve health systems' responsiveness towards adolescents' SRHR. This realist evaluation protocol will contribute to this knowledge in Zambia where there is increased attention towards promoting maternal, neonatal and child health as a means of addressing the current high early pregnancy and marriage rates. The protocol will ascertain: why, how, and under what conditions the integration of SRHR interventions into Zambian community health systems will optimise (or not) acceptability and adoption of SRHR services. This study is embedded within a randomized controlled trial - "Research Initiative to Support the Empowerment of Girls (RISE) "-which aims to reduce adolescent girl pregnancies and marriages through a package of interventions including economic support to families, payment of school fees to keep girls in school, pocket money for girls, as well as youth club and community meetings on reproductive health.

    Methods: This is a multiple-case study design. Data will be collected from schools, health facilities and communities through individual and group interviews, photovoice, documentary review, and observations. The study process will involve 1) developing an initial causal theory that proposes an explanation of how the integration of a community-based intervention that aimed to integrate adolescent SRHR into the community health system may lead to adolescent-friendly services; 2) refining the causal theory through case studies; 3) identifying contextual conditions and mechanisms that shape the integration process; and 4) finally proposing a refined causal theory and set of recommendations to guide policy makers, steer further research, and inform teaching programmes.

    Discussion: The study will document relevant values as well as less formal and horizontal mechanisms which shape the integration process of SRHR interventions at community level. Knowledge on mechanisms is essential for guiding development of strategies for effectively facilitating the integration process, scaling up processes and sustainability of interventions aimed at reducing SRH problems and health inequalities among adolescents.

  • 104.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Eriksson, Malin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Gender and health: aspects of importance for understanding health and illness in the world2015In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, article id 26908Article in journal (Refereed)
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