title: Adolescent school absenteeism and service use in a population-based study.
abstract: BACKGROUND
  School absenteeism is linked to a range of health concerns, health risk behaviors and school dropout. It is therefore important to evaluate the extent to which adolescents with absenteeism are in contact with health care and other services. The aim of the current study was to investigate service use of Norwegian adolescents with moderate and high absenteeism in comparison to students with lower rates of absence.
  
  
  METHODS
  The study employs data from a population-based study from 2012 targeting all pupils in upper secondary education in Hordaland County, Norway (the youth@hordaland-survey). A total of 8988 adolescents between the ages of 16 and 18 were included in the present study. Information on service use was based on adolescent self-report data collected in the youth@hordaland-survey. Absence data was collected using administrative data provided by the Hordaland County Council.
  
  
  RESULTS
  High absence (defined as being absent 15% or more the past semester) was found among 10.1% of the adolescents. Compared to their peers with low absence (less than 3% absence the past semester), adolescents with high absence were more likely to be in contact with all the services studied, including mental health services (odds ratio (OR) 3.96), adolescent health clinics (OR 2.11) and their general practitioner (GP) (OR 1.94). Frequency of contact was higher among adolescents with moderate and high absence and there seems to be a gradient of service use corresponding to the level of absence. Still, 40% of the adolescents with high absence had not been in contact with any services.
  
  
  CONCLUSIONS
  Adolescents with high absence had increased use of services, although a group of youth at risk seems to be without such contact. This finding suggests a potential to address school absenteeism through systematic collaboration between schools and health personnel.
authors.affiliation: Norwegian Institute of Public Health, Division of Mental Health, Department of Public Mental Health, Bergen, Norway. kristin.gaertner@fhi.no.|Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway. kristin.gaertner@fhi.no.
authors.forename: Kristin Gärtner
authors.initials: KG
authors.lastname: Askeland
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway. siren.haugland@uni.no.
authors.forename: Siren
authors.initials: S
authors.lastname: Haugland
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway. kjell.stormark@uni.no.
authors.forename: Kjell Morten
authors.initials: KM
authors.lastname: Stormark
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway. tormod.boe@uni.no.
authors.forename: Tormod
authors.initials: T
authors.lastname: Bøe
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway. mari.hysing@uni.no.
authors.forename: Mari
authors.initials: M
authors.lastname: Hysing
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D009664:Norway; D010379:Peer Group; D012309:Risk-Taking; D013332:Student Dropouts; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires