Self-reported health needs and use of primary health care services by adolescents enrolled in post-mandatory schools or vocational training programmes in Switzerland.
BACKGROUND
The second Swiss Multicenter Adolescent Survey on Health (SMASH02) was conducted among a representative sample (n = 7428) of students and apprentices aged 16 to 20 from the three language areas of Switzerland during the year 2002. This paper reports on health needs expressed by adolescents and their use of health care services over the 12 months preceding the survey.


METHODS
Nineteen cantons representing 80% of the resident population agreed to participate. A complex iterative random cluster sample of 600 classes was drawn with classes as primary sampling unit. The participation rate was 97.7% for the classes and 99.8% for the youths in attendance. The self-administered questionnaire included 565 items. The median rate of item non-response was 1.8%. Ethical and legal requirements applying to surveys of adolescent populations were respected.


RESULTS
Overall more than 90% of adolescents felt in good to excellent health. Suffering often or very often from different physical complaints or pain was also reported such as headache (boys: 15.9%, girls: 37.4%), stomach-ache (boys: 9.7%, girls: 30.0%), joint pain (boys: 24.7%, girls: 29.5%) or back pain (boys: 24.3%, girls: 34.7%). Many adolescents reported a need for help on psychosocial and lifestyle issues, such as stress (boys: 28.5%, girls: 47.7%) or depression (boys: 18.9%, girls: 34.4%). Although about 75% of adolescents reported having consulted a general practitioner and about one-third having seen another specialist, reported reasons for visits do not correspond to the expressed needs. Less than 10% of adolescents had visited a psychiatrist, a family planning centre or a social worker.


CONCLUSIONS
The reported rates of health services utilisation by adolescents does not match the substantial reported needs for help in various areas. This may indicate that the corresponding problems are not adequately detected and/or addressed by professionals from the health and social sectors.
Jeannin
André
A
Research Group on Adolescent Health (IUMSP/GRSA), University Institute for Social and Preventive Medicine, Lausanne University Hospital, Switzerland. Andre.Jeannin@hospvd.ch
Narring
Françoise
F
Tschumper
Annemarie
A
Bonivento
Laura Inderwildi
LI
Addor
Véronique
V
Bütikofer
Andrea
A
Suris
Joan-Carles
JC
Diserens
Chantal
C
Alsaker
Françoise
F
van Melle
Guy
G
Michaud
Pierre-André
PA
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D005260:Female; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013557:Switzerland