Communicating with adolescents in alternative health care sites.

Many adolescents have needs that are not always met in traditional medical settings. A number of sociomedical problems known as the new morbidities have presently emerged as national health-related problems among adolescents. However, in a recent national review, the 15 most frequent reasons for adolescent visits to a hospital or practitioner's office did not include these problems. We know that the major causes of death among adolescents are accidents, homicide, and suicide, and they experience untold mortalities related to teenage pregnancy, alcohol abuse, and drug abuse. Special programs are needed to address these problems. Our traditional health care facilities fail to reach the majority of high-risk adolescents. Through innovative programs such as Teen-Link, The Door, The Bridge over Troubled Waters, School Based Health Clinics, and other alternative health care facilities, many of these problems are being identified; and the at-risk population is targeted and served. Health care promotion and education have become major components of these programs. The key to attracting adolescent patients to these facilities has been the ability to reach out and serve them on their ground, and to effectively communicate with them despite their different socioeconomic and cultural backgrounds. No ideal approach to delivering health care exists for adolescent patients; however, a program that addresses their medical, social, educational, vocational, and psychologic needs may be utilized more frequently than programs that do not address the adolescent in a holistic manner. Further evaluation of these existing programs is necessary to assess which components are cost-effective, and which ones significantly affect the life-styles of adolescents as they progress toward adulthood.(ABSTRACT TRUNCATED AT 250 WORDS)