title: Gynecological care for adolescents with disability: physician comfort, perceived barriers, and potential solutions.
abstract: OBJECTIVE
  The goal of this study was to assess the barriers to gynecologic care for adolescents with disability in this state.
  
  
  METHODS
  Providers of gynecologic care in Utah were surveyed to assess existing conditions, attitudes, and comfort levels regarding this population.
  
  
  RESULTS
  The survey was completed by 136 gynecologic clinicians (50% return rate). The comfort level among surveyed clinicians in providing gynecological care to disabled adolescents was relatively low, even for routine screening. Respondents identified the following as barriers to providing this care: time, reimbursement, inadequate knowledge, and disability-related issues (office access and preference to not serve this population). Suggested solutions included: continuing education programs, consultation to practices on serving both youth and individuals with disability, and better billing mechanisms.
  
  
  CONCLUSIONS
  While many of the surveyed clinicians are comfortable providing care to adolescents with disability, a substantial number are not. Respondents perceive many barriers to providing care to this population, though the barriers appear modifiable. Potential interventions were identified which should be tested for their effectiveness in improving access to quality care for this underserved population.
authors.affiliation: University of Utah, Salt Lake City, Utah, USA.
authors.forename: Payal
authors.initials: P
authors.lastname: Shah
authors.forename: Chuck
authors.initials: C
authors.lastname: Norlin
authors.forename: Valerie
authors.initials: V
authors.lastname: Logsdon
authors.forename: Lisa
authors.initials: L
authors.lastname: Samson-Fang
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D006233:Persons with Disabilities; D004502:Education, Medical, Continuing; D005260:Female; D006176:Gynecology / Q000193:education; D006297:Health Services Accessibility; D006801:Humans; D012017:Referral and Consultation; D012051:Reimbursement Mechanisms; D013997:Time Factors; D014589:Utah