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  • Title: Supporting teenagers' use of contraceptives: a comparison of clinic services.
    Author: Herceg-Baron R, Furstenberg FF, Shea J, Harris KM.
    Journal: Fam Plann Perspect; 1986; 18(2):61-6. PubMed ID: 3792524.
    Abstract:
    A program to provide teenage family planning clinic patients with special services designed to improve their ability to practice contraception effectively and avoid conception produced neither of these expected effects. Two types of special services were tested in nine clinics: one, to promote greater involvement of the teenager's family through special counseling sessions (family support); and the other, to provide more frequent contact between the teenager and clinic staff through telephone calls (periodic support). The services were provided in the six weeks following the first clinic visit. Only 36 percent of the girls who agreed to be in the family support group attended any counseling sessions, and only five percent of them came with a parent. Participation was greater in the periodic support group--84 percent of teenagers in the group received the follow-up phone calls. During the 15 months following the initial clinic visit, there were no significant differences in regularity of contraceptive use and pregnancy rates between the teenagers who received the special support services and those who received only the regular clinic services. About 40 percent of the special-service groups reported always using a contraceptive method during the study period, compared with 48 percent of controls; and about 40 percent of the former said they had rarely or never used a method, compared with 27 percent of the latter. The cumulative 15-month pregnancy rate was about 13 percent in both the special-service and the control groups. A program to provide teenage family planning clinic patients with special services designed to improve their ability to practice contraception effectively and avoid conception produced neither of these expected effects. 2 types of special services were tested in 9 clinics: one, to promote greater involvement of the teenager's family through special counseling sessions (family support); and the other, to provide more frequent contact between the teenager and clinic staff through telephone calls (periodic support). The services were provided in the 6 weeks following the 1st clinic visit. Only 36% of the girls who agreed to be in the family support group attended any counseling sessions, and only 5% of them came with a parent. Participation was greater in the periodic support group--84% of teenagers in the group received the follow-up phone calls. During the 15 months following the initial clinic visit, there were no significant differences in regularity of contraceptive use and pregnancy rates between the teenagers who received the special support services and those who received only the regular clinic services. About 40% of the special service groups reported always using a contraceptive method during the study period, compared with 48% of controls; and about 40% of the former said they had rarely or never used a method, compared with 27% of the latter. The cumulative 15 month pregnancy rate was about 13% in both the special service and the control groups. Greater family involvement at the clinic site is not the magical program elixir that many critics of confidential services for teenagers have been hoping for. It was surprising that the periodic support group fared no better than the family support and control groups. 1 suggestive finding that did emerge was that adolescents who were assigned to the periodic support group but who never received any telephone calls were about 5 times as likely to become pregnant as the girls who were contacted by phone. The challenge of these results lies in the need they imply for other service models to be designed and tested.
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