Encouraging adolescents to contact their GP: a community-based trial

BACKGROUND: Adolescents, especially males, often fail to see their GP. AIM: To determine whether an informative letter could enhance the accessibility and utilisation of healthcare facilities and services. DESIGN AND SETTING: A community-based trial in one town in Oslo, using a retrospective control group. METHOD: GPs in one town in Oslo sent a personal, informative letter at the beginning of 2008 and 2009 to individuals in their practice population who were turning 16 years of age that year. The pooled data for the same year for each surgery were collected. Retrospective data from 1990 and 1991 served as controls for the intervention groups of data collected in 2006 and 2007 respectively. An International Classification of Primary Care-2 diagnosis was given for each contact. RESULTS: The proportion of adolescents in contact with a GP increased from 59% in the control group to 69% in the intervention group (P<0.001). For the males, the increase was from 54% to 72% (P<0.001). This reduced sex differences in healthcare seeking. For diagnoses mentioned in the informative letter the incidence rose from 38% in the control group to 55% in the intervention group (P<0.001). For the females, there was a non-significant increase in the proportion in contact with the GP, from 63% to 66% in control and intervention groups, respectively. The most frequent contact reasons were respiratory disorders, followed by general and unspecified complaints, skin disorders, musculoskeletal disorders, and psychological disorders. This pattern did not change because of the intervention. CONCLUSION: An information letter about health problems and health rights (such as the protection of the adolescent’s privacy) seems to enhance the accessibility and utilisation of GPs, as measured by contact rate, particularly for males.