社区医学与健康教育

抽象的

Promoting Adolescent Males' Health: Utilization of School-Based Youth Health Centers in Nova Scotia, Canada

Jacqueline C Gahagan, Timothy Jason and Carly Pender

The purpose of our mixed-methods study was to explore adolescent males’ perceptions of health service needs, utilization of youth health center services, as well as perceived barriers and facilitators to such utilization. The qualitative phase included interviews with educators and service providers, as well as youth of both sexes in order to gain preliminary information regarding the broader contextual issues related to males’ use of youth health centers. In-depth interviews were followed by separate focus group discussions with youth, health and social service providers, teachers and educators. The focus group discussions produced a number of key themes believed to influence youths’ decisions to access youth health centers, including: perceptions of help-seeking as a gendered social practice, lack of knowledge regarding the range of services offered by youth health centers, perceived stigma, and finally concerns related to issues of confidentiality and anonymity. Based on the qualitative analysis, the emergent themes were used to inform the development of a 76-item self-completion survey designed to provide an aggregate of male students’ perceptions of factors related to their use of youth health centers. Although more than 50% of the male respondents reported that they would feel comfortable using youth health center services in their school, only 16.5% had ever accessed a center, and only 5% indicated frequent use. The findings of this mixed methods study indicated a tension between certain gendered beliefs or what students should do in the event of a presenting health concern and intention or what students would do in the event of a health issue. This tension is governed, in part, by well-established gendered social norms and expectations regarding health seeking behaviors. Results also suggested a potential role for teachers and parents in further promoting youth health centers. Creating a supportive environment for male youth and normalizing male utilization of youth health centers represent necessary steps to addressing males’ chronic underutilization of these important services.