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Using a national survey of 8,500 New Zealand high school students, we investigated adolescents' concerns about their drinking, associated factors including help-seeking preferences and access to health care services, and how these varied by ethnicity and level of socioeconomic deprivation. Approximately 23.9% of the 3,704 current drinkers reported concerns (i.e., being worried about their drinking and/or having tried to cut down). Regression analyses revealed that Māori and Pacific youth were more likely than their New Zealand European peers to be concerned about their drinking. Concerned drinkers were more likely than nonconcerned drinkers to report hazardous drinking behaviors and alcohol-related problems, but these associations varied by age, ethnicity, and socioeconomic deprivation. Help-seeking preferences differed strongly by ethnicity. Concerned drinkers, and Māori and Pacific drinkers, were more likely to report difficulties accessing health care and alcohol and drug services. The factors associated with adolescents' drinking concerns and paradoxical difficulties accessing health care highlight the importance of engaging adolescents in developing responsive and equitable services.

Objective: To describe the health status over time of Māori secondary school students in New Zealand compared to European students., Methods: Anonymous representative health surveys of New Zealand secondary school students were conducted in 2001, 2007 and 2012 (total n=27,306 including 5,747 Māori)., Results: Compared to 2001, Māori students in 2012 experienced improved health, family and school connections. However, considerable inequity persists with Māori students reporting poorer health, greater exposure to violence and socioeconomic adversity compared to European students. When controlling for socioeconomic deprivation, inequity was substantially reduced, although worse Māori health outcomes remained for general health, mental health, contraceptive use, healthy weight, substance use, access to healthcare and exposure to violence. There was some evidence of convergence between Māori and European students on some indicators., Conclusions: There have been significant improvements for Māori youth in areas of health where there has been investment. Priority areas identified require adequate resourcing alongside addressing systematic discrimination and poverty. Implications for public health: Socioeconomic contexts, discrimination, healthcare access and identified priority health areas must be addressed to improve equity for Māori youth. Building on these gains and hastening action on indicators that have not improved, or have worsened, is required., (© 2018 The Authors.)

Objective: This study investigates the associations between living with a disabling condition and experiencing clinically attended injuries, risk behaviours and difficulties accessing healthcare for injury among adolescents attending secondary (high) schools in New Zealand., Methods: A nationally representative cross-sectional self-report survey conducted in 2012 captured health and well-being data from 8500 secondary school students using a multimedia computer-assisted interview. Respondents reporting a disability or a long-term condition with functional limitations were defined as adolescents with a disabling condition (index group of interest). The association between experience of disability (or not) and injuries, related risk factors and access to healthcare was investigated using logistic regression models., Results: One in six students (n=1268, 14.9%) reported a disabling condition. Compared with their peers, these students had significantly increased odds of needing treatment in the previous 12 months for an injury related to an RTC (OR 1.53; 95% CI 1.11 to 2.10), fall (OR 1.30; 95% CI 1.08 to 1.57), near drowning (OR 2.50; 95% CI 1.40 to 4.48), assault (OR 2.13; 95% CI 1.50 to 3.02) and self-harm (OR 4.25; 95% CI 3.03 to 5.96). Students with disabilities were also at increased odds of reporting they had problems accessing healthcare for injury (OR 1.51; 95% CI 1.27 to 1.81). Adolescents with disability were more likely than their peers to have been a passenger in a vehicle where the driver was under the influence of drugs (OR 1.29; 95% CI 1.03 to 1.62) or was driving dangerously (OR 1.40; 95% CI 1.21 to 1.62)., Conclusions: Acknowledging the likely underestimation of effects in a mainstream school survey, adolescents with disability face elevated odds of injury and yet have poorer access to healthcare. Environmental and systemic causes of these disparities require greater attention with implementation of effective interventions., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Problem: Youth with mild-moderate mental health concerns often go unrecognized, and find access to and the navigation of support services difficult., Methods: A quasi-experimental pre-/postintervention design was used to explore the impact of facilitated access to free counseling support using the following outcome measures: Strengths and Difficulties Questionnaire (SDQ), Substance Abuse Choices Scale (SACS), Children's Global Assessment Scale (C-GAS), alongside consumer feedback questionnaires., Findings: A total of 581 culturally diverse youth aged 10-24 completed the intervention. Those who completed reported significant improvements in global social and psychiatric functioning measured by C-GAS (p < .001); reduced risk of clinically significant mental health concerns measured by SDQ (p < .001); and reductions in the use and impact of drugs/alcohol measured by SACS (p < .001). Participants and their families/whānau reported that the interventions were safe and appropriate, with perceived increased skill development around coping and communication., Conclusions: This intervention appears to be an effective and acceptable strategy, particularly for Māori youth and those from lower socioeconomic groups, to reduce mild to moderate mental health symptoms and concerns. This approach could be replicated by other communities wishing to reduce mental health burden for youth by facilitating access to free, culturally appropriate, and accessible counseling via a multidisciplinary and collaborative triage approach., (© 2014 Wiley Periodicals, Inc.)

Objectives: To investigate the availability of youth-relevant community pharmacy services in New Zealand (NZ), and the opinions of pharmacy personnel on the appropriateness of these services for young people aged 12-24., Methods: Pharmacist and pharmacy support staff (PSS) questionnaires were developed collaboratively with a Youth Advisory Group (YAG) and were mailed to 500 randomly selected community pharmacies in NZ., Results: Response rates for questionnaires were 50.5 % for pharmacists and 37.0 % for PSS. The majority of community pharmacies in NZ offer public health services relevant to youth health including emergency contraception, condoms, smoking cessation, weight management and harm reduction services for drug use. Not all pharmacy personnel believed these services are appropriate for youth, particularly for those aged 16 or under. PSS appeared less likely than pharmacists to feel services were appropriate., Conclusions: Community pharmacies are offering an increasing range of youth-relevant health services, and may, therefore, be able to improve youth healthcare access. More research is required to investigate the barriers to young people accessing services from pharmacies, and also the challenges for pharmacy personnel in providing services to this age group.

Objectives: To investigate whether there is potential for community pharmacies to help increase healthcare access and address unmet health needs of young people in New Zealand., Methods: A descriptive secondary analysis of the Youth'07 health and wellbeing survey data was undertaken alongside discussion meetings with a youth advisory group., Key Findings: Seventeen per cent (n = 1485) of all students had been unable to access care when required in the previous 12 months. Of these students, 86.0% cited barriers to accessing health care that are unlikely to be barriers in a community pharmacy setting (e.g. not being able to get an appointment). Thirty per cent (n = 2475) of students had experienced difficulty accessing health care in the past 12 months for various health issues, with over half of these (n = 1326) citing a health issue for which community pharmacies could provide services (e.g. minor health issues, smoking cessation)., Conclusions: Although young people are generally considered to be fit and healthy, many have health needs that are currently unmet by traditional health services. Community pharmacies offer services that are relevant to youth health and are readily accessible to young people, indicating potential to help address unmet health needs and improve healthcare access. Further research is needed to explore how community pharmacy models of care might be provided in an appropriate and acceptable manner for youth., (© 2013 Royal Pharmaceutical Society.)

Background: The international youth population has significant unmet health needs, and there have been many calls to increase youth health care access. Community pharmacies may be able to help address these needs, but very little research has investigated this area and it is not known whether the current community pharmacy setting is acceptable or appropriate for youth., Objectives: 1) To obtain information on physical factors which could affect young people's use of community pharmacies in New Zealand, including accessibility, opening times and the physical youth-friendliness of the pharmacy environment. 2) To involve and utilize young people in the research process, in order to understand their needs and interpretation of survey data., Methods: This study applied a cross sectional survey design, informed by a sequential youth participatory approach. A questionnaire was developed in consultation with a youth advisory group (YAG). Questionnaires distributed to pharmacists at 500 randomly selected pharmacies nationwide between May and September 2011 collected information on whether the pharmacy met selected youth-friendly criteria. These included physical aspects of youth-friendliness, such as opening times and the pharmacy environment. The YAG also provided a youth perspective in the interpretation of the results., Results: Three mail shots achieved a response rate of 50.5%. Most respondents reported the pharmacy to be accessible by public transport and many had extended opening hours. Although most pharmacies met some youth-friendly criteria with regards to the pharmacy environment (e.g. having a private consultation area), more specific criteria (such as displaying youth health information) were usually not met. Interpretive feedback from the YAG highlighted areas for improvement., Conclusions: Pharmacies show potential as youth-friendly health care access points and most already meet some youth-friendly criteria. Areas identified for improvement will require a greater youth focus from the profession, and should be undertaken in consultation with young people. We recommend the use of youth participation approaches in future pharmacy practice research into youth health services., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objectives: We determined the association between availability and quality of school health services and reproductive health outcomes among sexually active students., Methods: We used a 2-stage random sampling cluster design to collect nationally representative data from 9107 students from 96 New Zealand high schools. Students self-reported whether they were sexually active, how often they used condoms or contraception, and their involvement in pregnancy. School administrators completed questionnaires on their school-based health services, including doctor and nursing hours per week, team-based services, and health screening. We conducted analyses using multilevel models controlling for individual variables, with schools treated as random effects., Results: There was an inverse association between hours of nursing and doctor time and pregnancy involvement among sexually active students, with fewer pregnancies among students in schools with more than 10 hours of nursing and doctor time per 100 students. There was no association between doctor visits, team-based services, health screening, and reproductive health outcomes., Conclusions: School health services are associated with fewer pregnancies among students, but only when the availability of doctor and nursing time exceeds 10 hours per 100 students per week.

Background: There are persistent ethnic gaps in uptake of child healthcare services in New Zealand (NZ), despite increasing policy to promote equitable access. We examined ethnic differences in the uptake of immunisation and primary healthcare services at different ages and quantified the contribution of relevant explanatory factors, in order to identify potential points of intervention. Methods: We used data from the Growing Up in New Zealand birth cohort study, including children born between 2009 and 2010. Econometric approaches were used to explore underlying mechanisms behind ethnic differences in service uptake. Multivariable regression was used to adjust for mother, child, household, socioeconomic, mobility, and social factors. Decomposition analysis was used to assess the proportion of each ethnic gap that could be explained, as well as the main drivers behind the explained component. These analyses were repeated for four data time-points. Results: Six thousand eight hundred twenty-two mothers were enrolled during the antenatal survey, and children were followed up at 9-months, 2-years and 4-years. In univariable models, there were ethnic gaps in uptake of immunisation and primary care services. After adjusting for covariates in multivariable models, compared to NZ Europeans, Asian and Pacific children had higher timeliness and completeness of immunisation at all time-points, while indigenous Māori had lower timeliness of first-year vaccines despite high intentions to immunise. Asian and Pacific mothers were less likely to have their first-choice lead maternity caregiver (LMC) than NZ Europeans mothers, and Māori and Asian mothers were less likely to be satisfied with their general practitioner (GP) at 2-years. Healthcare utilisation was strongly influenced by socio-economic, mobility and social factors including ethnic discrimination. In decomposition models comparing Māori to NZ Europeans, the strongest drivers for timely first-year immunisations and GP satisfaction (2-years) were household composition and household income. Gaps between Pacific and NZ Europeans in timely first-year immunisations and choice of maternity carer were largely unexplained by factors included in the models. Conclusions: Ethnic gaps in uptake of child healthcare services vary by ethnicity, service, and time-point, and are driven by different factors. Addressing healthcare disparities will require interventions tailored to specific ethnic groups, as well as addressing underlying social determinants and structural racism. Gaps that remain unexplained by our models require further investigation. [ABSTRACT FROM AUTHOR]

Aim: To report the prevalence of self‐reported chronic pain and severity among young people in New Zealand and explore the relationships between pain and mental health, substance use, socialisation and school engagement. Methods: Prevalence of self‐reported chronic pain frequency and severity are reported from an anonymous, representative cross‐sectional self‐administered health and well‐being questionnaire by students aged 12–18 years in New Zealand. Multivariable models exploring chronic pain and mental health, substance use, socialisation and school engagement are reported controlling for age, sex, ethnicity, socio‐economic status, disability and history of sexual abuse. Results: Overall, 22.8% (95% confidence interval (CI) 21.2–24.5) of young people reported chronic pain for 6 months or more, with 3.2% (95% CI 3.1–4.5) reporting severe pain weekly or more often. Females and rural adolescents were more likely to report chronic and severe pain. Asian youth reported less pain than other ethnic groups. Increased severity of pain was associated more with poorer daily functioning and socialising than with frequency of pain. Severe pain occurring weekly or more often was more common among students who had a disability (2.3% 95% CI 1.8–2.7 vs. 9.8%, 95% CI 7.2–12.5) or a history of sexual abuse (2.4% 95% 1.9–2.9 vs. 8.5%, 95% CI 6.3–10.5). Those reporting chronic pain had higher proportions of self‐reported significant depressive symptoms, lower well‐being, lower school engagement and lower access to health care, particularly for those reporting higher levels of intensity and frequency of pain. Conclusions: Chronic pain is common in adolescent populations, and has a significant association with decreased daily functioning, socialising, school engagement and mental well‐being. Adolescents with chronic pain report significant unmet health‐care needs. [ABSTRACT FROM AUTHOR]