Research

Adolescents report insufficient preventive health care in GP consultations: a qualitative study

Elodie Million, Léa Fabre, Bruno Falissard, François Carbonnel, Béatrice Lognos and Agnès Oude Engberink
BJGP Open 14 July 2026; BJGPO.2025.0054. DOI: https://doi.org/10.3399/BJGPO.2025.0054

Abstract

Background Adolescence is a period of empowerment and vulnerability that requires the early identification of risky behaviours to prevent them. Several prevention areas need to be addressed, including sexual health, mental health, substance use and addiction, diet, physical activity, orthopaedic disorders, vaccinations, screen use, and social relationships. Prevention plays an important role in primary care all over the world. Consultation between an adolescent and their GP can be complex. While there are professional recommendations, they rarely address all prevention areas.

Aim To understand adolescents’ experiences of preventive health care during consultations with GPs.

Design & setting This qualitative study used semi-structured interviews with adolescents in France, aged between 11 years and 24 years.

Method Individual interviews took place with 12 participants. Analysis was conducted based on grounded theory and triangulated for the identification of conceptualising categories.

Results Twelve interviews led to the identification of the following three conceptualising categories: (1) prevention in adolescents is primary prevention and is multifaceted; (2) limited preventive involvement by the attending physician: adolescents seek information from other sources with varying influence on their behaviour; and (3) adolescents tend to justify GPs’ limited preventive engagement.

Conclusion Adolescents trust their GP. Despite the use of different prevention sources, not all recommended topics are discussed with adolescents. Leveraging the experiences of adolescents, we can confirm that GPs have to be more involved in preventive care during consultations with adolescents. These consultations are complex, and it is necessary to offer support tools for GPs and other primary healthcare professionals, based on the needs of adolescents.

How this fits in

Primary healthcare professionals, and GPs in particular, should address all areas of preventive health care when consulting with adolescents, but it can be complex and difficult to manage. For adolescents in our study, the preventive health approach is on primary prevention and is multifaceted, but the GP is not very involved. Adolescents are looking for reassurance about their normality and need to talk about preventive health with their GP. The GP has an important role to play, particularly in the most intimate issues (sexual health, mental health, or violence), which were not discussed in all families.

Introduction

Adolescence is a period of empowerment and vulnerability that requires the early identification of risky behaviours. This identification enables a preventive approach to be implemented with the aim of reducing morbidity and mortality.1–4 Numerous areas of preventive health care need to be addressed: sexual health, mental health, substance abuse and addiction, diet, physical activity, orthopaedic disorders, vaccinations, screen use, and social relations.5–9 Healthcare professionals should ideally address all these areas of prevention when consulting with adolescents. Prevention plays an important role in primary care all over the world, particularly in Europe and North America.10–12 There are recommendations and many tools on prevention for adolescents in primary care consultation.7,8,13,14 However, these recommendations essentially focus on a single theme such as nutrition,15–17 mental health,4,18–20 or sexual health.21–24 Adolescents have expectations regarding healthcare professionals25,26 but there is a lack of literature on their expectations regarding preventive care. Tools and recommendations about prevention should be based on adolescents' needs.

We plan to create a digital tool to help with preventive health care during consultations with adolescents. This tool will be available to doctors and healthcare professionals who see adolescents in consultations. Before creating the tool, it was necessary to ask adolescents about their experiences of preventive care with their GPs. We have chosen to focus on consultations with GPs because they are the most frequently consulted by adolescents in France. In this way, the tool can be adapted to the needs expressed by adolescents.

We conducted a qualitative study using semi-structured interviews to understand the preventive healthcare experience of adolescents during consultations with their GPs. Our aim was to suggest methods to improve preventive care.

Method

Study design

We conducted a qualitative study of adolescents in France. Semi-structured interviews were conducted by one researcher (LF). LF received specific training in qualitative interviews and analysis by an expert in qualitative research (EM). LF used an interview guide focused on lived experiences, developed by two experts in qualitative research (AOE, EM) and pre-tested on a sample of three adolescents of different ages (21 years, 20 years, and 12 years). These three interviews were included in the analysis. The guide was based on literature data, using open-ended questions to gain an in-depth understanding of the adolescent’s experiences; there were no modifications after the test interviews (Table 1).

View this table:
Table 1. Interview guide

Participants

Adolescents living in Occitanie region of France, aged between 11 years and 24 years, were recruited following requests from the principal investigator (LF), and were sampled using the snowball sampling method. The combination of direct invitation and recruitment by snowball sampling method allowed us to diversify the purposive sample, which was otherwise too homogenous. A purposive sample (that is, a targeted sampling of adolescents who were competent to answer the research questions) was sought, with maximum variation in personal experience such as age, gender, and educational background.

Data collection

Individual in-depth interviews took place at home or by videoconference. The location of the interviews was chosen by the adolescent. The interviews began with a written information sheet and questionnaire to collect the participants' characteristics, followed by the investigator obtaining the interviewees’ written consent to participate in the study and their agreement to audio-recording. The written consent of parents of children aged <18 years was recorded too. The recording was destroyed immediately after verbatim transcription. We have kept the transcripts for analysis. The participants were informed of the study objectives and that they could stop the interview at any time without giving a reason.

We created a paper document listing validated preventive care websites in France. This document was offered to the adolescents at the end of the interviews.

Data analysis

The recorded interviews were transcribed verbatim. The text was then analysed using floating reading and annotation: the verbatims were read several times, with notes added in the margins and in a separate document. Continuous comparisons enabled the identification of conceptual categories, based on a grounded theory model27 (Table 2). We aimed to explore and understand the experiences of the adolescents rather than develop a theory.27–29 No analytical software was used. The analysis was carried out when the interviews were completed, until data saturation was reached. Two further interviews were required to confirm this saturation.30 Two researchers (LF and EM) triangulated the data employing inductive content analysis, using a process of constant comparison between the text and categories. This strict methodology ensured the internal validity of the study.

View this table:
Table 2. Data analysis29

Results

Participants

Fifteen young people were contacted to propose participation in this study. All had initially agreed to be interviewed. Three adolescents changed their minds and declined to take part in the interview when a date had to be found. Twelve interviews were conducted between May 2023 and the end of January 2024: data saturation was achieved after ten, and two additional interviews were carried out to confirm this. Seven female and five male participants between the ages of 12 years and 22 years (median age of 16 years) were interviewed (see Table 3 for participant characteristics). The average length of the interviews was 37 minutes. Seven interviews were conducted at the participants' homes and five by videoconference.

View this table:
Table 3. Characteristics of the participants

Conceptualising categories

Three conceptual categories were identified from verbatims (summarised in Table 4).

View this table:
Table 4. Conceptual categories

Prevention in adolescents is primary and multifaceted

Preventive care for adolescents mainly takes the form of primary prevention. It takes many forms, both personalised and collective, with the aim of helping them to modify their health-risk behaviour

For adolescents, prevention was a means of limiting the onset of hereditary or acquired diseases. Prevention addressed several themes to understand the possible consequences of the adolescent’s behaviour on their health. The daily prevention themes (sleep, nutrition, hearing and vision, and dental health) were designed to enable immediate action, sometimes with family support, with the aim of achieving good health with long-term consequences:

‘... prevention is something that is done to prevent us from doing bad things.’ (P1, M, 20 years)

‘I'd like to have [...] information on how to eat well or how to lead a healthy life, [...] I'd like someone to talk to me about that!’ (P2, F, 22 years)

Primary prevention could be achieved through massive behavioural prevention messages aimed at the general population. Adolescents remembered television campaigns during the COVID-19 epidemic, protection campaigns against sexually transmitted infections, or high-impact, graphic campaigns against domestic violence or road accidents. Adolescents described a wide range of prevention mediums (intervention in schools, television, photographs on packs of cigarettes), some of which were inappropriate or shocking depending on the age at which they were exposed to them:

‘... prevention against smoking [...] it’s massive, it’s everywhere, [...] on cigarette packets, on bus stops, streetcar stops, on TV... everywhere!’ (P1, M, 20 years)

Screening was described by adolescents as another means of preventive care. They described individual screening when testing for sexually transmitted infections with a sexual partner, essentially to consider condom withdrawal during sex, or individual screening for cancers when there were family risk factors:

‘I can think of “cancer”, but I think there are other diseases that can be screened for, and I don't think enough is done [...]’ (P1, M, 20 years)

For adolescents, prevention meant identifying risk situations, especially those involving violence and mental health. These situations of violence or psychological suffering had to be identified as early as possible to limit their future impact. Adolescents described the transition from high school to higher education as a period that precipitates psychological suffering and fragility in young people: detection should therefore be commonplace, systematic, and widespread during this period of change, in order to overcome the societal taboo associated with these themes. GPs should systematically identify young people’s mental health problems and offer them easier access to free consultations with psychologists:

‘I'm thinking of a questionnaire, that’s good! [...] that we send to all the mailboxes, [...] "Help for students" and a little questionnaire with answers "... Are you adapting to your new life?", "Are you encountering any problems?"’ (P8, F, 18 years)

The adolescents identified the notion of public health in the prevention approach. When it came to vaccinations, the adolescents perceived an external obligation to carry them out, imposed by families and legislation with the overall health objective of eradicating certain diseases. However, they had no control over their own vaccinations; it was the family who took them and the doctor who vaccinated them. Adolescents found a collective interest in tackling topics that are taboo in society (addiction, mental health, violence); it enabled them to be attentive to those around them and to share prevention information:

‘It wouldn't be useful for me, but maybe I could share it with others. So […] it’s still useful to talk about it.’ (P7, F, 16 years)

Limited preventive involvement by the attending physician: adolescents seek information from other sources, with varying influence on their behaviour

GPs have little involvement in adolescent health prevention. Adolescents therefore experience prevention via multiple channels, such as school, various digital media, and family and peers, with varying impact on their behaviour. Whatever the source of the prevention message, the influence of peers and the young person’s personal experience have a strong impact on behaviour change.

Adolescents seldom consulted their GP, and the prevention they could provide seemed rarely offered. Even if the GP was a reliable source of information for the adolescents, the information given was not widely accepted. Adolescents were looking for reassurance about their normality and their identification with the group of healthy young people. The GP therefore had an important role to play in addressing the most intimate issues (sexual health, mental health, or violence), which were not discussed in all families:

‘Always give as much information as possible about the body and how adolescents function — future adults, in fact! And reassure them as much as possible.’ (P5, F, 19 years)

‘... for the doctor, because since he’s studied so hard […], well, he’s in a position to tell me everything I need to know!’ (P7, F, 16 years)

In the school environment, prevention varied; for example, during general courses in high school, during interventions by outside professionals (road safety), or during higher education. Adolescents had an ambivalent experience of prevention in the school environment. It was felt to be too redundant, even if repetition led to better assimilation; when in school, the ‘learning mindset’ was conducive to memorisation of prevention messages, but the topics covered were always the same:

‘... as a health student, I'm aware of this, but "just a little", [...] people who do ordinary studies, [...] they don't know the subject, so there’s even more risk for them.’ (P0, F, 21 years)

Audiovisual and digital media, such as TV commercials and reports, social networks, and websites, were important sources of information for adolescents. These preventive messages were effective because of their visual impact, ease of access, and the daily use of these digital tools by young people. Adolescents appreciated peer testimonials, particularly on topics considered taboo in society or families (violence, and sexual or mental health). However, adolescents were concerned about the unreliability of the witnesses and the irrelevance of the solutions offered in these non-expert testimonials.

‘But they warn us on the Internet, they warn us with flashes on TV, they give us little reminders.’ (P5, F, 19 years)

‘On social networks, [...] young adolescents or young adults say “Oh, but I didn't know. I thought I was the only one and that I was the weird one."’ (P5, F, 19 years)

Some families were a source of information in adolescent prevention. Some subjects related to everyday life (sleep) were easily broached, while others — more taboo in society — were difficult to discuss (such as sexual health and mental health). When one of the parents worked in the medical–social field, all preventive topics were discussed more frequently, and the subjects felt less taboo:

‘Families talk a lot about this, these open subjects, it’s not taboo. You can talk about anything, etc. [but] there will be subjects that are completely closed.’ (P4, M, 17 years)

In adolescence, identification with the peer group was important, and this influenced the adolescent’s personal behaviour. However, the adolescents interviewed pointed out that personal awareness could be stronger than the effect of the group; the young person reflected on the group’s behaviour and might not imitate it if they perceived it as inappropriate:

‘I don't know what I would have done if all my group of friends had told me “Don’t use a condom, it’s rubbish, etc.”. I don't know [...]. For example, as [...] almost all my friends smoke. I don't smoke. But anything to do with casino [...], sports betting, they've dragged me into it, so [...] it depends.’ (P1, M, 20 years)

Whatever the prevention channel used, the youth’s individual experience and age always strongly influenced the impact of prevention on their behaviour. Prevention messages and themes had to be tailored to each adolescent and discussed in understandable, age-appropriate language, especially when it came to sexuality and addictions. In the event of a personal pathology or a pathology affecting a close relative, the adolescent was made aware of the health risks associated with these pathologies:

‘Well, that’s good, but I don't really care [laughs]! I mean, it’s okay, I'm not old enough!’ [sexuality] (P3, F, 12 years)

‘As for hearing, well, you realise that when you play music too loudly, it can hurt your ears a bit.’ (P9, M, 12 years)

Adolescents tend to justify GPs’ limited preventive engagement

GPs do not talk much about prevention in their consultations, but adolescents made excuses for this; for example, a GP consultation is short, formulaic, too infrequent, and without room for prevention; the GP lacks knowledge and time; and the presence of a third party or the professional’s good knowledge of the young person’s environment makes prevention pointless.

Consultations with their GPs were not conducive to prevention messages. Adolescents were ambivalent about the possibility of suitable subjects other than the initial reason for consulting the doctor, which hindered prevention. They did not feel entitled to question the doctor directly on topics they wished to discuss but declared the doctor ‘irrelevant’ if they spontaneously broached topics unrelated to the initial reason for consultation. Moreover, consultations with the GP were stereotyped, leaving little room for anything other than the initial reason for consultation: questioning, examination, and prescription of appropriate therapies.

‘it’s not really the subject, [...] And it’s complicated to take a subject to something else [...]. I don't think I'd necessarily be able to ask.’ (P2, F, 22 years)

The adolescents felt that GPs did not think to mention preventive care in their consultations because they were not familiar with recent recommendations. Adolescents justified this lack of knowledge by citing the numerous prevention topics to be addressed and the time-consuming ongoing training required of the doctor. Adolescents felt that certain areas of prevention did not fall within the GP’s remit, and so they would not discuss them in a consultation; for example, it would be more appropriate to discuss vision with an ophthalmologist, and contraception or sexuality with a gynaecologist:

‘There’s a lot of prevention to be done and it must take a lot of work.’ (P2, F, 22 years)

For adolescents, preventive care and the GP’s time were not compatible; short consultation times were not conducive to prevention, which was considered time-consuming. There was the loss of chance for other ‘really’ sick patients if the doctor wasted time talking about preventive care. In addition, it was felt the time period between two consultations with the GP was too long, rendering ineffective prevention messages, which were forgotten by adolescents:

‘if he takes a lot of time for people who don't necessarily have a problem, well then... Bah it’s a waste of time.’ (P4, M, 17 years)

Being the GP could complicate the preventive approach to the adolescent

Familiarity with the adolescent and the family justified the GP’s failure to address certain issues, especially those relating to sporting activities. On the other hand, some more intimate topics, such as sexuality, addictions, or mental health, required a closer relationship with the practitioner, so that the adolescent could confide in them. The parents were often present at the consultation with the adolescent. This third party made communication between the GP and the adolescent more difficult owing to lack of listening to the adolescent, and direct communication to the third party by the doctor. This impaired communication was not conducive to preventive discourse:

‘Imagine I smoke, I can't see talking about it with her or even alcohol [...] I'm not close enough to talk about it!’ (P8, F, 18 years)

Adolescents justified the limits of primary prevention by GPs in certain areas

Doctors might fear a feeling of judgment or stigmatisation on the part of the adolescent: for example, nutrition or sports activities in the case of overweight, or prevention messages concerning drug use, which were only addressed if the adolescent indicated that they were taking them.

‘No, [...] maybe in my head, I'll think “if he’s talking about it [addiction], it means he thinks I'm doing it.”’ (P3, F, 12 years)

Discussion

Summary

Three conceptualising categories were identified from the 12 interviews: (1) prevention in adolescents is primary prevention and is multifaceted; (2) limited preventive involvement by the attending physician: adolescents seek information from other sources with varying influence on their behaviour; (3) adolescents tend to justify GPs’ limited preventive engagement.

Strengths and limitations

Our study contributes to optimising adolescent preventive care. It offers novel insights about preventive care delivered by primary healthcare professionals; no previous study has addressed this topic in the same way. The strength of our study lies in its methodological rigour and compliance with the recommendations of the Consolidated Criteria for Reporting Qualitative Research (COREQ) grid,30including maximum variation in the sample, triangulation of the analysis with a researcher who is an expert in qualitative research, iterative adaptation of the interview guide, concurrent analysis, and triangulation of the analysis with an expert in qualitative research. Some comments from participants might only apply to specific prevention areas, which is a limitation. The method was based on the researcher’s reformulations during the interviews, the triangulation of the analysis, and the constant comparison analysis method. This methodological rigour led to the identification of more general conceptual categories that took into account the lived experience of the participants in our study as a whole. If an adolescent perceived prevention through one or more areas only, the result was considered relevant because it explains their perception of prevention during consultations. The interviewer (LF) was not an expert in qualitative research but received targeted training from experts (EM and AOE) to conduct interviews and the analysis of verbatims. This rigorous qualitative method contributes to the internal and external validity of this study.

Comparison with existing literature

For adolescents, preventive care should take the form of primary prevention. GPs interviewed in a previous study conducted by our team also recommended primary prevention as early as possible to limit the negative consequences of risky behaviour.31 Adolescents described the GP as uninvolved in their preventive care. Studies have asked GPs about this subject; for example, GPs described an adolescent world that was difficult to understand, and consultations that were too complex. GPs’ justifications for their lack of involvement in prevention were in line with the comments given by adolescents: GP consultations are too short, too stereotyped, and adolescents do not feel able to raise subjects. However, GPs, like other primary care professionals, could be privileged interlocutors for adolescents on the subject of prevention, especially if the relationship and communication were of good quality.31,32 Adolescents in our study said that they rarely consulted their GP. During these consultations, prevention was rare. The literature confirms that adolescents consult few doctors, whatever their specialty.6 However, in France, GPs are the doctors most frequently consulted by adolescents, even if these consultations are rare.5 GPs therefore have an essential role to play in health prevention for adolescents and young people. Vergne et al’s study confirmed that during consultations, GPs talked about prevention, even if the initial reason for consultation was unrelated for those aged 13–24 years.6

Our study confirms that GPs are not the only medium for adolescent’s prevention. Adolescents are exposed to prevention messages through family, school, and audiovisual prevention campaigns, but above all through peer groups and social networks. Identification with peers is important for adolescents: this need for identification can influence their decisions, including regarding risky behaviour, so any preventive action must take this into account if it is to be effective.33–36 The family environment played a role in prevention among adolescents; for example, in primary prevention as well as in relaying prevention messages from the GP or national and school prevention campaigns. Good parental habits influenced children’s behaviour, mainly regarding everyday issues such as nutrition, sport, and sleep.37 GPs must therefore take this parental influence into account in their preventive support for adolescents. So, the place of family doctor is a facilitating factor. Parents could be helpful in the preventive approach, but also a hindrance, as in the case of vaccination recommendations: parents may promote vaccination and accompany their adolescent towards the GPs’ office, or on the contrary, may oppose vaccination because of their own hesitations or erroneous beliefs.38,39 However, a 2019 study showed that early intervention with parents about parent–adolescent communication helped to reduce risky behaviour and alcohol consumption among adolescents.40

Participants reported that most prevention content for adolescents targeted only a few themes: essentially sexual health, taking toxic substances, or nutrition. A 2017 study confirmed that GP consultations do not cover all the recommended topics.6 GPs, as well as other primary care professionals, have an important role to play in optimising preventive practices among adolescents by complementing the prevention messages received through other mediums.37,41

Adolescents recognise the important role of the GP in preventive care in intimate areas such as sexual and mental health, but they know little about the GP’s skills, have difficulty in spontaneously broaching the subject, or are uncomfortable with the idea of the GP broaching it themselves. A clear and direct message from the GP on all prevention issues could facilitate discussion on these topics. The adolescent could be reassured about the GP’s knowledge and skills. Adolescents were looking for better ways of detecting and dealing with psychological suffering. The literature confirms the existence of effective mental health prevention measures.4,42–44 Adolescents identified the period of entry into higher education as particularly risky in terms of mental health, which is confirmed by the literature.45 Primary healthcare professionals are relevant for enhancing the identification and prevention of mental health issues among adolescents: recommendations exist in different countries.10,14,46 Schools and families must also be involved in the prevention of mental health problems in adolescents.43,47–50 As Patel et al reminded us in a 2007 Lancet article, mental health of young people is ‘a global public-health challenge’.20

The adolescents we interviewed had expectations regarding the preventive care delivered from their GPs. A qualitative study carried out by our team among GPs proposed recommendations in line with these expectations:31 prevention for adolescents during the consultation must be opportunistic, personalised, multiple, and based on the relationship of trust that the GP develops through monitoring the child and family.

For adolescents, prevention messages and themes had to be tailored to each adolescent. These needs for personalisation apply regardless of the professional involved in prevention: primary healthcare professionals, teachers, national authorities, and so on. The influence of the teenager’s personal experience on the perception and consequences of prevention messages has been described in numerous international studies; for example, the influence of adolescent personality on smoking prevention,51 the influence of adolescents' psychosocial skills on substance abuse prevention,52 and the influence of family medical history on adolescent health risks.53 Taking into account the specific characteristics of adolescents in terms of their personal skills, their family, friends, cultural environment, and their past experiences is essential to the effectiveness of prevention measures, which must be personalised.10,54,55 Adolescents in our study expect age-appropriate prevention. In our study, we chose a large broad definition of adolescence, from 11–24 years of age. The needs of those aged 12 years at secondary school, who have rarely experienced sexual relations and live with their parents, are bound to be different from those aged 24 years who are already immersed in the world of work or studying at university. It is therefore necessary for healthcare professionals to identify and communicate prevention messages that are adapted to the age of the adolescent, but also to their life history.1,56

Adolescents in our study did not always identify GPs as sources of prevention support because they were unfamiliar with their functions. Prevention is an important part of the role of the GP and primary care, as confirmed by numerous studies and international recommendations.6,10,31,57 The literature shows that parents and adolescents expect to receive information from primary care professionals58 and that they trust their healthcare professional if they are honest, respectful, empathetic, and respect confidentiality.59 GPs, as family doctors, have a legitimate role to play in this preventive mission. This preventive mission is facilitated by knowledge of the adolescent’s socio-familial environment and the relationship GPs have developed with the child and then the adolescent.12,31,33

GPs interviewed in the previous study conducted by our team recommended consultation aids to optimise the preventive approach, based on pre-consultation questionnaires, digital tools, and dedicated long consultations.31 These strategies may help facilitate more open dialogue with adolescents,31,60 who may not feel empowered to raise sensitive topics with their GPs. This proposal would be particularly interesting and complementary to the proposal made by the adolescents in our study to systematise, normalise, and better address mental disorders in young people.

Implications for research and practice

Adolescents perceived that GPs were not sufficiently involved in adolescent preventive care. Additionally, they found that preventive messages from other mediums were too narrowly focused on specific themes. GPs need to invest more and better in their prevention work with adolescents, because they have the advantage of a special relationship with the adolescent, which makes it easier to discuss more intimate subjects. The development of a digital prevention tool for primary care professionals could help GPs to optimise consultations with adolescents and implement a preventive approach covering all recommended themes. Our study will enable us to refine the content of this tool to meet the expectations of adolescents.

Notes

Funding

No funding.

Ethics approval statement

The study was approved by a National Ethics Committee (CNGE 260123431).

Provenance

Freely submitted; externally peer reviewed.

Data

Data are available on request from the corresponding author.

Patient consent

All study participants provided informed consent.

Acknowledgements

Thank you to the adolescents in our study for their participation and the wealth of their responses. Thanks to Pr Hervé Maisonneuve for his invaluable help in writing this article.

Competing interests

The authors declare that no competing interests exist.

  • Received March 11, 2025.
  • Revision received August 10, 2025.
  • Accepted October 3, 2025.

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Adolescents report insufficient preventive health care in GP consultations: a qualitative study
Elodie Million, Léa Fabre, Bruno Falissard, François Carbonnel, Béatrice Lognos, Agnès Oude Engberink
BJGP Open 14 July 2026; BJGPO.2025.0054. DOI: 10.3399/BJGPO.2025.0054
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British Journal of General Practice