title: Rural adolescents' access to adolescent friendly health services.
abstract: BACKGROUND
  The purpose of this study was to assess rural North Dakota adolescents' experiences in accessing adolescent-friendly health services and to examine the relationship between rural adolescents' communication with health care providers and risk behaviors.
  
  
  METHODS
  Data are from the Rural Adolescent Health Survey (RAHS), an anonymous survey of 14- to 19-year-olds (n = 322) attending secondary schools in four frontier counties of North Dakota. Descriptive statistics were used to assess participants' access to adolescent-friendly health services characterized as accessible, acceptable, and appropriate. Logistic regressions were used to examine whether participant-reported risk behaviors predicted communication with health care providers about individual health risk behaviors.
  
  
  RESULTS
  Rural adolescents reported high access to acceptable primary health care services but low levels of effective health care services. Participant report of engaging in high-risk behaviors was associated with having received information from health care providers about the leading causes of morbidity and mortality.
  
  
  CONCLUSIONS
  These findings reveal missed opportunities for primary care providers in rural settings to provide fundamental health promotion to adolescents.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Secor-Turner
authors.forename: Brandy A
authors.initials: BA
authors.lastname: Randall
authors.forename: Alison L
authors.initials: AL
authors.lastname: Brennan
authors.forename: Melinda K
authors.initials: MK
authors.lastname: Anderson
authors.forename: Dean A
authors.initials: DA
authors.lastname: Gross
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000592:standards; D003430:Cross-Sectional Studies; D055317:Evidence-Based Practice; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006266:Health Education; D006293:Health Promotion / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009658:North Dakota / Q000453:epidemiology; D011314:Preventive Health Services / Q000458:organization & administration; D012309:Risk-Taking
keywords: Adolescent; health services; rural