title: Health professionals' and managers' definitions of developmentally appropriate healthcare for young people: conceptual dimensions and embedded controversies.
abstract: We aimed to (i) explore how health professionals and managers who work with young people seek to define developmentally appropriate healthcare (DAH), (ii) identify the range of conceptual dimensions present in their definitions and (iii) explore the controversies embedded in their characterisations of DAH.
  
  
  
  A qualitative multisite ethnographic study was conducted across three hospitals in England. We undertook face-to-face semi-structured interviews with health professionals and managers; and non-participant observation in clinics, wards and meetings. Anonymised field notes and interview transcripts were analysed using thematic analysis. The theme 'conceptualisations of DAH' was then further analysed, and the resulting themes categorised to form conceptual dimensions.
  
  
  
  We recruited 192 participants and conducted 65 interviews (41 with health professionals and 24 with managers) and approximately 1600 hours of non-participant observations (involving 103 health professionals and 72 managers). Despite the wide range of definitions provided by participants, five conceptual dimensions of DAH were identified: (i) biopsychosocial development and holistic care, (ii) acknowledgement of young people as a distinct group, (iii) adjustment of care as the young person develops, (iv) empowerment of the young person by embedding health education and health promotion and (v) interdisciplinary and interorganisational work. Also, some controversies were identified within most dimensions.
  
  
  
  This study illustrates the lack of a generalised definition of DAH for young people among UK health professionals and managers, and presents a set of five core dimensions that can inform future research to help define and evaluate DAH for young people.
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
authors.forename: Albert
authors.initials: A
authors.lastname: Farre
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Wood
authors.affiliation: Centre for Musculoskeletal Research, University of Manchester, Manchester, UK.
authors.forename: Janet E
authors.initials: JE
authors.lastname: McDonagh
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Parr
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK.
authors.forename: Debbie
authors.initials: D
authors.lastname: Reape
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Rapley
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D016497:Adolescent Health Services / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration*; D004739:England; D006302:Health Services Research / Q000379:methods; D006694:Holistic Health; D006801:Humans; D036301:Qualitative Research
keywords: Adolescent Health Services; Developmentally Appropriate Healthcare; Qualitative research; Young Adults; Youth-Friendly Health Care