TAG Research Reviews 

Access to High-Quality, Teen Friendly Health Care 

Office of Adolescent Health | Website: http://www.hhs.gov/ash/oah/TAG Twitter: @TeenHealthGov Email: TAGTEAM@hhs.gov 

“Adolescents benefit from access to high-quality medical and dental care, mental and behavioral 

health services, and to health care providers who understand adolescent health and development. 

Young patients prefer health services that are youth-friendly, culturally competent, affordable, 

convenient, and confidential. Health care that is adolescent-centered and involves parents, but 

allows for increased autonomy as adolescents reach their late teens, is ideal.”

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Adolescent Health: Think, Act, Grow® (TAG) Research Reviews highlight research, evaluation reports, 

and other publications that inform the field about key issues in, and effective practices for, fostering 

improved health, reducing risky behavior, and improving engagement and healthy development in 

young people. This Research Review focuses on Access to High-quality, Teen-friendly Health Care, 

one of TAG’s Five Essentials for Healthy Adolescents. 

Addressing the health needs of adolescents transitioning out of foster care.2

There is currently no formalized system of transition to meet the health needs of adolescents before they 

are discharged from the foster care system. The authors provide several recommendations for primary 

care providers who are guiding an adolescent through the transition process: 1) assess health care needs; 

2) provide care coordination; 3) increase the adolescent's knowledge of their health conditions and ability 

to resolve health care issues; 4) assist the adolescent in accessing health insurance; 5) set up community 

services such as employment, housing, and education through social work; and 6) identify an adult primary 

and specialty provider for continued health care. Read more

Barriers to seeking mental health services among adolescents in military families.3

Adolescents in military families report multiple emotional and behavioral concerns, including the loss of 

interest in activities, social withdrawal, changes in sleeping and eating, sadness, irritability, worry about 

their parent’s safety, and disrespectful behavior. Although these concerns have been documented, military 

families with adolescents do not tend to seek or utilize mental health services. This study examined the 

barriers to mental health treatment experienced by adolescents in enlisted military families, military (nonenlisted) parents, and the mental health service providers who treat adolescents in military families. The 

authors identified several barriers to engaging in mental health services across the three groups, including

confidentiality concerns, stigma, time and effort, logistical concerns, and financial concerns. Read more

Barriers to sexual and reproductive health care: Urban male adolescents speak 

out.4

The prevalence of sexually transmitted diseases (STDs) is higher in adolescents (ages 15–24) than in any other 

age group and young males with untreated STDs are at risk for serious and long-term consequences, such as 

sterility, disability, and increased vulnerability to HIV. This study explored minority adolescent males’ 

perceptions of and attitudes toward reproductive healthcare services in their community. The adolescents 
Office of Adolescent Health | Website: http://www.hhs.gov/ash/oah/TAG Twitter: @TeenHealthGov Email: TAGTEAM@hhs.gov 

reported multiple internal and external barriers to receiving sexual health services. Internal barriers included 

stigma, perceived loss of social status, shame, and embarrassment, while external barriers included 

disrespectful providers, a lack of privacy/confidentiality, and challenges in accessing and negotiating the 

healthcare system. The authors recommend making physical surroundings more welcoming and comfortable 

to male adolescents, including a dedicated waiting room and/or clinic time for adolescent patients and a 

private reception area where clients can state their reason for seeking care out of earshot of other patients. 

Read more

CHIP: New opportunities in adolescent health care delivery.5

Children's Health Insurance Programs (CHIP), usually targeted to infants, toddlers, and school-aged children, 

are now mandated to provide access to adolescent health consumers. The authors found three barriers 

(psychological, institutional, and financial) to successful adolescent health care delivery that may reduce the 

potential impact of CHIP for advancing adolescent health care. The authors recommend straightforward forms 

to enroll teens in CHIP programs, allowing adolescents to self-enroll, and providing enrollment opportunities in 

community settings such as schools, recreation centers, and other adolescent-friendly locations. Read more

Comparing health and mental health needs, service use, and barriers to services

among sexual minority youths and their peers.

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Sexual minority youth (SMYs), defined as youth who report same-sex romantic attractions or relationships or 

who identify as non-heterosexual, may be at higher risk for an array of poor health and mental health 

outcomes in comparison with their heterosexual peers. Using quantitative data from the National Longitudinal 

Study of Adolescent Health (Add Health) school-based survey, SMYs’ self-reported data indicated higher 

prevalence rates on all indicators of health and mental health needs, including sexual activity; sexually 

transmitted disease diagnoses; perceived risk for HIV/AIDS; levels of anxiety, depression, suicidality; and 

physical and sexual victimization. When asked about health service use and barriers, significantly more SMYs

reported that they had skipped needed medical care in the past year compared to their peers. Reasons cited 

for skipping care included: did not want parents to know, afraid of what the doctor would say or do, and could 

not pay. Based on these findings, the authors recommend that school and office-based health providers 

consider whether their services are welcoming and offer sufficient assurances of confidentiality to facilitate 

access by SMYs. Read more

Foregone mental health care and self-reported access barriers among 

adolescents.

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Approximately 1 in 10 children and adolescents in the United States suffers from mental illness severe enough 

to cause some level of impairment, yet fewer than one in five of these youth receives needed care in any given 

year. The term “foregone mental health” refers to untreated or unmet mental health needs. Access to 

appropriate, quality mental health services continues to be a public health concern for American youth. This 

study assessed barriers to mental health care for youth who reported ever needing psychological or emotional

counseling. The most commons barriers reported by both boys and girls to mental health care included: 

thought or hoped the problem would go away and didn’t want parents to know. Other reported barriers 

included: didn’t know where to go, couldn’t pay, afraid of what the counselor would say or do, and hard to find 

time. Read more
Office of Adolescent Health | Website: http://www.hhs.gov/ash/oah/TAG Twitter: @TeenHealthGov Email: TAGTEAM@hhs.gov 

Management of child and adolescent obesity: Attitudes, barriers, skills, and 

training needs.

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The high prevalence of childhood and adolescent obesity, coupled with short-term and potential long-term 

health implications, highlights the need for obesity-related clinical services including assessment, treatment, 

and preventive care for children and adolescents. While childhood and adolescent obesity has been 

documented, little is known about health care professionals' attitudes, perceived barriers (e.g., lack of parental 

involvement), skill level, and training needs in relation to the treatment of childhood and adolescent obesity.

The most frequent barriers cited by practitioners were lack of parent involvement, lack of patient motivation, 

lack of support services, lack of reimbursement, and lack of clinician time. When assessing skill level and 

interest in training, the most common areas of self-perceived low proficiency were in the use of behavioral 

management strategies, guidance in parenting techniques, and addressing family conflicts. This study 

highlights the need for increased education and training opportunities on prevention and treatment 

approaches for childhood and adolescent obesity. Read more

On-site mental health care: A route to improving access to mental health services 

in an inner-city, adolescent medicine clinic.9

Approximately six to nine million children and adolescents in the United States have mental health 

problems, with up to 19% of all pediatric visits involving psychosocial problems that require intervention. 

Given the lack of mental health care utilization among youth, the authors assessed whether providing an 

on-site (e.g., teen health center) adolescent medicine clinic would improve the rate of patients first 

meeting with a mental health provider, compared with patients referred off-site to mental health 

providers through their insurance companies. The authors found that on-site counseling is more conducive 

to adolescents making their appointments and continuing with counseling (67% of participants), compared 

with those referred to off-site counseling (n=0). This study showed that access to mental health care can 

be improved by placing a counselor on-site, within the setting of the adolescent medicine clinic, and

allowing the clinic staff to schedule the appointments for that counselor. Read more

Perceptions of oral health, preventive care, and care-seeking behaviors among 

rural adolescents.10

According to the CDC, 50% of low-income children and 66% of low-income adolescents have experienced 

dental cavities in the United State due to dental-related problems. Given these findings, this study sought 

to identify perceptions of oral health and access to dental care among a sample of low-income, minority 

adolescents. Respondents indicated several barriers to oral health care access, including: lack of both 

money and Medicaid providers, parental unavailability for dental appointments, and fear of the dentist. 

Recommendations for improving oral health care access for adolescents include having dental services 

available at school-based health centers and increasing efforts to incorporate components of oral health 

education into the school curriculum. Read more

The role of school health centers in health care access and client outcomes.11

School-based health centers represent a model of care that responds to the unique physical and mental health 

issues of adolescents by offering care in an accessible, youth-friendly environment. This study examined the

impact of 12 school health centers in Alameda County, California on clients' access to care, satisfaction, and 

reproductive and mental health outcomes. Compared with other usual sources of medical care (e.g., Kaiser 
Office of Adolescent Health | Website: http://www.hhs.gov/ash/oah/TAG Twitter: @TeenHealthGov Email: TAGTEAM@hhs.gov 

Permanente, doctor’s office, community clinic), the authors found that school health centers were the most 

commonly reported source of medical, family planning, and mental health counseling services for adolescents.

Read more

 

 
 

1 U.S. Department of Health and Human Services, Office of Adolescent Health. (April, 2016). Adolescent Health: 

Think, Act, Grow® 2016 playbook. Washington, D.C.: U.S. Government Printing Office. 

2

 Lopez, P., & Jackson, P. L. (2007). Addressing the health needs of adolescents transitioning out of foster care. 

Pediatric Nursing, 33(4), 345-355. 

3

 Becker, S. J., Swenson, R. R., Cataldo, A. M., P., Esposito-Smythers, C., & Spirito, A. (2014). Barriers to seeking 

mental health services among adolescents in military families. Professional Psychology: Research & Practice, 

45(6): 504-513. doi:http://dx.doi.org/10.1037/a0036120. 

4

 Lindberg C., Lewis-Spruill C., & Crownover, R. (2006). Barriers to sexual and reproductive health care: Urban 

male adolescents speak out. Issues in Comprehensive Pediatric Nursing, 29(2): 73-88. doi: 

10.1080/01460860600677577. 

5

 Diaz, A., Edwards, S., Neal, W., Ludmer, P., Bitterman, J., & Nucci, A. T. (2004). CHIP: New opportunities in 

adolescent health care delivery. Mount Sinai Journal of Medicine, 71(3): 186-190. 

6

 Williams, K. A., & Chapman, M. V. (2011). Comparing health and mental health needs, service use, and barriers 

to services among sexual minority youths and their peers. Health & Social Work, 36(3): 197-206. 

7

 Samargia, L. A., Saewyc, E. M., & Elliott, B. A. (2006). Foregone mental health care and self-reported access 

barriers among adolescents. Journal of School Nursing, 22(1): 17-24.

8

 Story, M. T., Neumark-Stzainer, D. R., Sherwood, N. E., Holt, K., Sofka, D., Trowbridge, F. L., & Barlow, S. E. 

(2002). Management of child and adolescent obesity: Attitudes, barriers, skills, and training needs. Pediatrics, 

110(1): 210-214. 

9

 Lieberman, A. Adalist-Estrin, A., Erinle, O., & Sloan, N. (2006). On-site mental health care: A route to improving 

access to mental health services in an inner-city, adolescent medicine clinic. Child: Care, Health & Development, 

32(4), 407-413. doi:10.1111/j.1365-2214.2006.00620.x. 

10 Dodd, V. J., Logan, H., Brown, C. D., Calderon, A., & Catalanotto, F. (2014). Perceptions of oral health, 

preventive care, and care-seeking behaviors among rural adolescents. Journal of School Health, 84(12): 802-809. 

11 Soleimanpour, S., Geierstanger, S. P., & Kaller, S. (2010). The role of school health centers in health care access 

and client outcomes. American Journal of Public Health, 100(9): 1597-1603. doi:10.2105/AJPH.2009.186833.

Office of Adolescent Health | Website: http://www.hhs.gov/ash/oah/TAG Twitter: @TeenHealthGov Email: TAGTEAM@hhs.gov