Diminished Trust of Healthcare Providers, Risky Lifestyle Behaviors, and Low Use of Health Services: A Descriptive Study of Rural Adolescents.
Heather K Hardin, Valerie Lander McCarthy, Barbara J Speck and 1 others
PMID 28823198WHAT IT FOUND
For rural adolescents, trust in healthcare providers was higher when they had a usual source of care and lower with Medicaid or transportation difficulty.
Outpatient use was lower with low income, poor health, no insurance, or no felt need.
Key findings
01Trust in healthcare providers was higher among adolescents with a usual source of care, with healthier lifestyle behaviors, and without transportation difficulty, and lower among those with Medicaid compared with private insurance.
02Healthier lifestyle behaviors were associated with excellent or very good self-rated health, younger age, higher trust in healthcare providers, and female sex.
03Low household income was associated with less outpatient use and more emergency use, while no insurance, poor self-rated health, and no self-perceived need were associated with less outpatient use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only one rural high school and a convenience sample of Grades 9 and 12 students were studied, so results may not apply to other adolescents. The design measured trust, lifestyle, and health service use at one time, so it cannot show which came first or whether one caused another. All data were self-reported, including diagnosed conditions, trust, lifestyle, and visits. Many eligible students were absent or had stopped attending, so the final sample may not represent all students in the school. The trust scale had not been used before with adolescents ages 14 to 19, although it had good reliability in this sample. The study did not ask about informal sources of health information, such as family, friends, or the Internet, which may affect service use. The influence of recent health policy changes was not known.
The easy way to misread this
Do not read the lower outpatient use as proof that rural adolescents need less care. The study was a single cross-sectional survey with self-reported visits, and participants reported many diagnosed conditions.