title: Experience of Primary Care Services Among Early Adolescents in England and Association With Health Outcomes.
abstract: OBJECTIVE
  The aim of this study was to investigate adolescents' (11-15 years) experience of their general practitioner (GP), whether poor reported GP experience was associated with worse physical and mental health measures and whether poor previous GP experience was linked to lower utilization of these services.
  
  
  METHODS
  We used logistic regression to analyze data from the 2014 Health Behaviour in School-aged Children study. Four aspects of recent care experience were studied: feeling at ease, feeling treated with respect, satisfaction with doctor's explanation, and feeling able to discuss personal matters. Five dichotomized measures of health status were used: ever self-harmed; fair or poor self-reported health; frequent (at least weekly) low mood; sleeping problems; or headaches.
  
  
  RESULTS
  Of 5,335 students, 4,149 reported having visiting their GP within the past year. Of these, 91.8% felt treated with respect, 78.7% felt at ease, 85.7% were satisfied with explanation, and 53.9% felt able to discuss personal matters. After adjusting for ethnicity, age, gender, and family affluence score, poor experience on any indicator was strongly associated with increased risk of self-harm (adjusted odds ratio range, 2.01-2.70; all p < .001); feeling low (AOR range, 1.53-2.11; all p < .001); and sleeping problems (AOR range, 1.49-1.91; all p ≤ .001). Poor experience on all indicators, except discussing personal matters, was associated with worse self-reported health.
  
  
  CONCLUSIONS
  Nearly half of this large, national study of adolescents did not feel able to discuss personal matters with their doctor. There was a consistent, strong association between reported lack of good GP experience and poor health measures.
authors.affiliation: Population, Policy, and Practice Programme, UCL Institute of Child Health, London, United Kingdom. Electronic address: arrash@cantab.net.
authors.forename: Arrash A
authors.initials: AA
authors.lastname: Yassaee
authors.affiliation: Population, Policy, and Practice Programme, UCL Institute of Child Health, London, United Kingdom.
authors.forename: Dougal S
authors.initials: DS
authors.lastname: Hargreaves
authors.affiliation: Adolescent, Child, and Family Health Research Unit, Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, United Kingdom.
authors.forename: Kayleigh
authors.initials: K
authors.lastname: Chester
authors.affiliation: Herne Hill Group Practice and The Well Centre, London, United Kingdom.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lamb
authors.affiliation: Association for Young People's Health, London, United Kingdom.
authors.forename: Ann
authors.initials: A
authors.lastname: Hagell
authors.affiliation: University of Technology, Sydney, New South Wales, Australia.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Brooks
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D017677:Age Distribution; D001294:Attitude to Health; D002648:Child; D004739:England; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D017678:Sex Distribution; D013222:State Medicine / Q000592:standards; D014944:World Health Organization
keywords: Adolescent; GP; Health measures; Patient experience; Primary care; Student