Developing youth-friendly family practice.

Family physicians with full practices and busy schedules struggle to help youth who present with pressing health issues and complicated lives. Our own offspring report difficulty finding primary care as they become independent. Our experience helping youth and young adults negotiate complex resource-constrained systems of care has posed challenges and contradicts the belief that youth do not need or want much health care. All youth are potentially at risk of adverse health and mental health outcomes, owing to environmental factors, family situations, personal choices, or social pressures. Youth are less likely than adults to seek or receive primary care and they experience more gaps in health and mental health care than adults do.1 The health attitudes and behaviour youth develop in adolescence and early adulthood have a lasting effect on their health, wellbeing, and life course as adults. Youth need primary care that is sensitive to their unique stage of biologic, cognitive, and psychosocial transition to adulthood.2 To understand how primary care can support the health of youth, we conducted a systematic literature review on youth access and engagement with health and mental health services (page 778).3 Key principles and activities that support youth-friendly practice emerged. We met with local high-school youth to ask how they would like youth health care to be offered in our community. Then we attempted to incorporate these findings into a more youth-friendly practice. Some changes have been easy to implement, and some require more resources and time. A report found in the literature review provided a framework for the evidence that emerged. The framework, developed by Kang et al4 from practice and research with youth in Australia, is based on 7 key principles: accessibility, evidence-informed practice, youth participation, collaboration, professional development, sustainability, and evaluation. This framework guides our commentary, which is intended to foster conversation on supporting youth-friendly practice.