Study instruments
| Study instrument | WHO tool | Key adaptations | Concepts measured in study instrument |
| FGD: Semistructured focus group discussions utilising participatory methods: body mapping, priority ranking and service mapping. | Adolescent in the community interview tool (quant survey) | Original quantitative tool was developed into a qualitative instrument to gather rich formative data. | Strengths (what keeps you strong) and challenges (main problems and concerns); enablers and barriers to accessing primary healthcare; and opportunities to strengthen services (ideal service design, what services does it provide, skills of providers). |
| IDI_adol: Semistructured in-depth interviews with young people with chronic illness | As above | As above. These IDIs are focused around the lived experiences as opposed to FGDs above that explore issues broadly. | As above but focussing on the lived experiences of young people with chronic illness who are likely high users of primary care. |
| KII: Semistructured key informant interviews with parents, Elders and community members. | Adult in community interview tool (quant. survey) | Adapted from quantitative survey so as to generate rich formative data. | Perceived strengths and challenges for young people; enablers and barriers to young people accessing primary healthcare services; opportunities to strengthen care. |
| Review of deidentified patient management data | N/A | N/A | Retrospective audit (24 months) of clinic data. Key indicators include: age, gender, clinic being accessed, principle reason for the person’s presentation, and whether this presentation was part of a well person’s check (715 MBS item billed). |
| Facility checklist | Observation tool and facility checklist (16 items) | Instrument largely maintained as recommended by WHO, with additional items included to capture cultural safety. | Facility operating hours, waiting area set up and information (including cultural relevance), availability of key medicines and equipment, client privacy and confidentiality, guidelines and decision support tools. |
| Anonymous client feedback. To be self-completed and deposited following clinical service. | Adolescent client exit interview tool (Survey) 34 questions | Adapted WHO tool to a simple survey (including visual rating scales) that can be self-completed for feasibility. | Age and gender, what services provided (including elements of psychosocial assessment), satisfaction with services including cultural safety of those services, opportunities to improve service provision. |
| Health provider survey | Healthcare provider interview tool (Survey) 35 items | Core content maintained, adapted to include larger emphasis on current practices and needs around support and training (so as to inform a potential response). | Current role, reasons for having seen adolescents in clinic, current services provided when seeing young people (including psychosocial screening), knowledge around adolescent care and legislation, use of guidelines and tools, needs around training and support, and recommendations to improve care to adolescents. |
| IDIhw: Semistructured Key informant interviews with healthcare providers | Based on health provider survey (as above) | Adapted from quantitative survey so as to generate rich formative data. | Perceived health issues for young people, enablers and barriers for young people well-being and services access, service delivery, opportunities to strengthen care (with focus on supply side). |
This table shows the study instruments, their adaptation from WHO tools and concepts measured. Instruments are provided in the online supplemental appendix.
FGD, focus group discussion; N/A, not available.