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Marginalised young people’s access to healthcare in the digital age

13 July 2017

Teenager's hands with phoneIn Australia today, young people aged between twelve and twenty-four are the only population whose health is not improving. Within this age bracket, there are rising rates of diabetes and sexually transmissible infections, and high rates of mental disorders according to a recent report on the health and wellbeing of young Australians published by the Australian Institute of Health and Welfare. A major determinant of health for young people is the ease of access to health care. Little is known however about the role of digital technology in the help-seeking behaviour of young people and what impact this has on their approach to health care.

Associate Professor Melissa Kang, The Australian Centre for Population and Public Health Research (ACPPHR), aims to improve access to health care for young people in the digital age in her current research project Access 3: Young people’s health care journeys. The research will explore how technology is integrated into health seeking behaviour and decision-making, and investigate young people’s use of online clinical interventions. With the 24/7 availability of health information on the internet, and more clinical interventions delivered online, digital technology is an integral part of health literacy. “Young people use digital technology as part of their everyday lives,” says Associate Professor Kang, “it seems obvious that they will turn to the internet if they are worried about their health. What we don’t know is how this leads to making decisions about whether to access health care, and which health services they will choose and why.”

Associate Professor Kang’s multifaceted and mixed-methods Access 3 study, funded by NSW Health, aims to further the impact of early studies Access 1 (2000 – 2002) and Access 2 (2002 – 2004), the findings of which have been incorporated into the youth health policies of NSW and other states in Australia in recent years. Extending on previous research, the current Access 3 study, which began in 2015, comprises four parts. It includes a state wide survey of over 1400  young people and a longitudinal study that follows  forty marginalised young people over twelve months  to explore the ways they use digital technology to support their navigation of health services. The young people targeted are from five subpopulations; Aboriginal and/or Torres Strait Islanders, young people experiencing homelessness, those of refugee or vulnerable migrant backgrounds, sexually and gender diverse young people and those living in rural or remote parts of the state. Forty percent of the young people surveyed fell under more than one of these marginalised groups. 

The research also includes a qualitative study of health professionals and senior managers across the state and a policy translation forum, a unique feature of the study design which places the integration of research findings parallel with the research process itself. This policy translation component has had a direct impact on the new NSW Youth Health Policy which was released at the 2017 AAAH Youth Health Conference in early July.

The need for workforce capacity building and professional development was a key finding from earlier Access research and remains an area that needs attention. Associate Professor Kang notes, “Young people want their health providers not only to have a good understanding of their health conditions, but who will treat them with respect and make them feel welcome at their service. There have been many examples where these have not been the experiences of marginalised young people.”

Specifically targeted sampling populations and strong engagement with stakeholder groups, such as the NSW Health:Western NSW Local Health District and the Orange Aboriginal Medical Service, has enabled more access to these marginalised groups that need the most support. The project’s institutional support facilitates broader research dissemination and more effective implementation of new policies and practices that are designed to improve healthcare outcomes for marginalised Australian young people.