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  • Title: Characteristics associated with contraceptive use among adolescent females in school-based family planning programs.
    Author: Brindis C, Starbuck-Morales S, Wolfe AL, McCarter V.
    Journal: Fam Plann Perspect; 1994; 26(4):160-4. PubMed ID: 7957817.
    Abstract:
    Among 162 young female family planning clients at four school-based health centers, a step-wise regression analysis shows that students' consistency of contraceptive use is associated with only a few specific service and provider characteristics. For example, clients who have more contacts with the family planning program use contraceptives more consistently than those with fewer contacts. On the other hand, young women whose follow-up visits are scheduled to occur within one month of their previous visit are less consistent contraceptive users than other clients. Contraceptive use is not related to whether contraceptives are dispensed on site, whether health education and counseling are provided by a health educator, whether contraceptive services are part of a comprehensive array of services that include medical or counseling services, or whether a family planning visit results in the dispensing of contraceptives or a prescription for contraceptives. The study population included 162 adolescent female clients at 4 California school-based health clinics in secondary schools, who used reproductive services at least once during the 1990-91 school year. The total population of family planning clients during this period at the 4 sites was 744. Students (201) were selected who had at least 3 months of family planning visits between the first and the most recent visit. The profile included 80% females, 63% Hispanic females, 25% Black females, 7% Filipino females, 2% non-Hispanic White females, 1% Asian or Pacific Islander females, and 2% of other ethnicity. Contraceptive use was measured as a ratio of the number of months of contraceptive use at every act of intercourse to the number of months of involvement in family planning services. A month without sexual activity counted as continuous use. The range of use was 0-29 months. Linear and stepwise regression analyses were performed. The results showed no significant relationship between client characteristics and contraceptive use. A significant relationship was found, however, between the number of family planning visits and contraceptive use. The greater the number of family planning contacts, the higher the contraceptive use ratio. Each contact increased use by 3%. Less consistent contraceptive use was associated follow-up visits within a month of the previous visit. The contraceptive use ratio was not significantly related to availability of contraceptives on site, the type of health educator, the receipt of additional counseling or medical services, or dispensing contraceptives at each visit. Factors explaining contraceptive use were low at 7%. The inverse relationship at one-month follow-up may indicate that high-risk students are being identified, but the program is unable to convince student to maintain contraceptive use. Alternative approaches may be necessary to both identify high risk for contraceptive discontinuation users and to deal with poor contraceptive use. A study limitation was the selection process and the small number of subjects; the clinic's primary clients came for mental health or primary care visits. Student enrollment at the 4 schools was 9390 and almost 50% reported sexual activity, of which 33% reported frequent or consistent use of contraceptives.
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