Youth Health – Building Bridges to General Practice
Program Contact Person
Activities/Achievements
Across the life span, young people represent the age group with the highest prevalence of mental health problems and disorders. They are also a group that is more likely to present symptoms related to psychological or behavioural disorders (e.g., suicide, depression, alcohol and drug dependence) rather than symptoms related solely to physical illness.
Unfortunately, many young people do not seek professional help for their health problems. Although GPs provide 100 million consultations to 80% of the Australian population, as a population group, young people are generally not utilizing health services to the extent of their representation in the community.
The primary aim of the IDGP Youth Health Program is to reverse this trend. First, by updating Illawarra GPs with relevant evidence-based information, and second, by promoting the health care provided by GPs to young people within the school setting.
Building Bridges to General Practice
Youth health training
There have been a number of youth health training workshops for Illawarra GPs. Over the past five years, workshop content has targeted needs identified by research conducted with Illawarra GPs and largely in collaboration with the Illawarra Institute for Mental Health at the University of Wollongong. GPs have been updated with research findings, practice tips, and newly developed resources in a number of information areas including the engagement, assessment, and management of young people.
The most recent series of workshops was held from January to February 2004 and focussed on overcoming barriers to engaging and referring young people when additional health care is necessary. Workshops included the dissemination of an evidence-based resource (The Youth Friendly GP Kit) and participation in research. Results from this research are currently being prepared for publication and presentation.
Building Bridges to General Practice – GPs in Schools
The Building Bridges to General Practice training and outreach program represents an example of how recommendations from prevention research are being applied to encourage and increase young peoples’ engagement in general practice. As the title suggests, Building Bridges was written as a prevention program that aims to “build bridges” to general practice through school-based outreach that addresses identified barriers to young people seeking health care. Through GP outreach, Building Bridges aims to improve young peoples’ access to health care from GPs and other health care providers so that more young people might consult a GP for physical and psychological problems.
Building Bridges has a strong research base and includes several components. The first major component involves GP training that addresses GP’s own attitudes and beliefs about help-seeking, gives GP’s information about young peoples’ help-seeking and barriers to consulting a GP, and trains GPs in communicating with young people and classroom presentation. The second major component of Building Bridges involves outreach and has trained GPs go into schools and present structured lesson plans that were written to specifically address at least some of the barriers identified through research.
From April to July 2003, a trial of the first version of Building Bridges was conducted in an Illawarra High School. Supporting the program aims, the controlled evaluation found that five and ten weeks after the Building Bridges presentation, the trial group reported significant decreases in their barriers to consulting a GP, and significant increases in their intentions to consult a GP for physical and psychological problems. This was in contrast to the control group who reported no significant changes across time.
On the basis of additional results from this initial trial, Building Bridges 2nd Edition was developed. From January to June 2004, a controlled trial and evaluation of this 2nd Edition of the program was conducted in three Illawarra High Schools in collaboration with the New South Wales Department of Education and Training, the Illawarra Institute for Mental Health (University of Wollongong), and Lifeline South Coast.
In a report on the evaluation of the Building Bridges program (Building Bridges to General Practice: Illawarra Evaluation Report), the results appear to strongly indicate that reductions in perceived barriers to care and increases in intentions to seek help for psychological problems occurred as a consequence of the Building Bridges presentations. In addition, for those who received the Building Bridges presentation, there was a significant relationship between their intentions to seek help and actual GP consultations. One of the more intriguing findings was the pattern of correlations that reflected help negation between the Trial and Control groups over time. The help negation relationship involves a negative correlation between suicidal ideation and intentions to seek help. That is, higher levels of suicidal ideation are associated with lower help seeking intentions. The study shows that for the Trial group, the strength of these correlations decreases sequentially over time. In the Control group the strength of the relationship remains essentially the same between baseline and at 10 weeks.
Together, these results suggest the Building Bridges program has positive effects on variables associated with young peoples’ help seeking from General Practitioners. It is also possible that Building Bridges may have a weak effect on help negation for suicidal thoughts but this would need to be confirmed by further research. With further refinement it may be possible to further strengthen these positive outcomes.
The project will again be rolled out to up to five Illawarrra High Schools in 2006.
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