Development of youth friendly family medicine services in Bosnia and Herzegovina: protocol for a cluster randomized controlled trial

Dagmar M Haller; Françoise Narring; Patty Chondros; Daliborka Pejic; Ana Sredic; Senad Huseinagic; Nicolas Perone; Lena A Sanci; Anne Meynard

doi:10.1186/2193-1801-3-319

Development of youth friendly family medicine services in Bosnia and Herzegovina: protocol for a cluster randomized controlled trial

Springerplus. 2014 Jun 26:3:319. doi: 10.1186/2193-1801-3-319. eCollection 2014.

Authors

Dagmar M Haller¹, Françoise Narring², Patty Chondros³, Daliborka Pejic⁴, Ana Sredic⁴, Senad Huseinagic⁵, Nicolas Perone⁶, Lena A Sanci³, Anne Meynard⁷

Affiliations

¹ Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland ; Department of community, primary care and emergency medicine, Geneva University Hospitals, 4 av Gabrielle-Perret-Gentil, 1211 Geneve 14, Switzerland ; Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland ; Department of General Practice, The University of Melbourne, Melbourne, Australia.
² Department of community, primary care and emergency medicine, Geneva University Hospitals, 4 av Gabrielle-Perret-Gentil, 1211 Geneve 14, Switzerland ; Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland.
³ Department of General Practice, The University of Melbourne, Melbourne, Australia.
⁴ Foundation fami, Doboj, Bosnia & Herzegovina.
⁵ Public Health Institute of Zenica-Doboj canton, Zenica, Bosnia & Herzegovina.
⁶ Department of community, primary care and emergency medicine, Geneva University Hospitals, 4 av Gabrielle-Perret-Gentil, 1211 Geneve 14, Switzerland.
⁷ Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland.

Abstract

Background: Young people face many barriers in accessing health services that are responsive to their needs. The World Health Organization has led a call to develop services that address these barriers, i.e. youth-friendly health services. Addressing the needs of young people is one of the priorities of Foundation fami, an organisation working in collaboration with the Swiss Federal Department of Development and Cooperation and Geneva University Hospitals to develop quality family medicine services in Bosnia and Herzegovina. This paper describes the design of a trial to assess the effectiveness of a multifaceted intervention involving family medicine teams (primary care doctors and nurses) to improve the youth-friendliness of family medicine services in Bosnia and Herzegovina.

Methods/design: This is a stratified cluster randomised trial with a repeated cross-sectional design involving 59 health services in 10 municipalities of the canton of Zenica in Bosnia and Herzegovina. Municipalities were the unit of randomisation: five municipalities were randomised to the intervention arm and five to a wait-list control arm. Family medicine teams in the intervention arm were invited to participate in an interactive training program about youth-friendly service principles and change processes within their service. The primary outcome was the youth-friendliness of the primary care service measured using the YFHS-WHO + questionnaire, a validated tool which young people aged 15 to 24 years complete following a family medicine consultation. A total of 600 young people aged 15 to 24 years were invited to participate and complete the YFHS-WHO + questionnaire: 300 (30 per municipality) at baseline, and 300 at follow-up, three to five months after the training program.

Discussion: The results of this trial should provide much awaited evidence about the development of youth-friendly primary care services and inform their further development both in Bosnia and Herzegovina and worldwide.

Trial registration: Australian New Zealand Clinical Trials Registry_ ACTRN12610000142033.

Keywords: Adolescent health services; Cluster randomised trial; Family practice; Quality of healthcare; Youth-friendly services.