Family planning for teens: strategies for improving outreach and service delivery in public health settings

Abstract

The persistent underuse of family planning services by inner-city, low-income, sexually active youth underscores the importance of testing innovative programs that maximize participation. Presented in this paper is an analysis of a Chicago public health clinic's special program for adolescents that originated from the staff's observations of the scheduling, educational, and support needs of teens seeking family planning services from a traditionally managed public health facility. Between December 1982, when the special program--the Teen Clinic--was implemented, and March 1985, more than 600 adolescents sought social support and contraceptive services--an 82 percent increase in new-patient registration compared with the enrollment before the program began. In contrast, two neighboring public health department facilities without special family planning programs for teens experienced either a small increase, 4 percent, or a modest decrease, 17 percent, in utilization by teenagers during the same period. The increased use of the study facility by teens, coupled with patients' self-reported nonuse of alternative sources of care and referral patterns, suggests that the new program was successful in recruiting sexually active teens who had previously been inadequately protected against pregnancy. The perceived institutional and interpersonal factors influencing 153 teens' initial and repeated use of the Teen Clinic, as measured by a structured survey, echo the findings of previous research. Strategies suggested by the study's findings for improving outreach and service delivery are described.