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. 2015 Nov;57(5):488-95.
doi: 10.1016/j.jadohealth.2015.07.013. Epub 2015 Sep 15.

Improving the Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Care Services

Lisa M Romero  1 , Dawn Middleton  2 , Trisha Mueller  3 , Lia Avellino  2 , Rachel Hallum-Montes  2
Affiliations

Improving the Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Care Services

Lisa M Romero et al. J Adolesc Health. 2015 Nov.

Abstract

Purpose: The purposes of the study were to describe baseline data in the implementation of evidence-based clinical practices among health center partners as part of a community-wide teen pregnancy prevention initiative and to identify opportunities for health center improvement.

Methods: Health center partner baseline data were collected in the first year (2011) and before program implementation of a 5-year community-wide teen pregnancy prevention initiative. A needs assessment on health center capacity and implementation of evidence-based clinical practices was administered with 51 health centers partners in 10 communities in the United States with high rates of teen pregnancy.

Results: Health centers reported inconsistent implementation of evidence-based clinical practices in providing reproductive health services to adolescents. Approximately 94.1% offered same-day appointments, 91.1% had infrastructure to reduce cost barriers, 90.2% offered after-school appointments, and 80.4% prescribed hormonal contraception without prerequisite examinations or testing. Approximately three quarters provided visual and audio privacy in examination rooms (76.5%) and counseling areas (74.5%). Fewer offered a wide range of contraceptive methods (67.8%) and took a sexual health history at every visit (54.9%). Only 45.1% reported Quick Start initiation of hormonal contraception, emergency contraception (43.1%), or intrauterine devices (12.5%) were "always" available to adolescents.

Conclusions: The assessment highlighted opportunities for health center improvement. Strategies to build capacity of health center partners to implement evidence-based clinical practices may lead to accessibility and quality of reproductive health services for adolescents in the funded communities.

Keywords: Adolescent reproductive health services; Evidence-based clinical practices; Teen pregnancy; Youth-friendly reproductive health services.

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