Community health centers improving teen reproductive health service through patient-centered care

The declining national adolescent birth rate is not extending to ethnically diverse communities. Communities with higher Latino populations see twice the national rate of teen birth and pregnancy rates, and higher sexually transmitted infection (STI) rates. Most adolescent reproductive health services occur in schools and family planning centers. However, school services are often limited to educational interventions and family planning centers may not exist in under-served communities and may be avoided due to stigma regarding STI. Federally qualified health centers (FQHCs) and similar community-based health clinics have a strong presence in under-served communities with generally high teen birth rates. They represent an important opportunity to improve access to educational and clinical services known to prevent unintended pregnancies and STIs. One of the largest Office of Adolescent Health programs, Teen Pregnancy Prevention (TPP), is being implemented in California's Central Valley through a collaboration of FQHCs and academic partners. TPP consists of one initial and three follow-up visits over 6 months. During visits, trained health educators use a patient-centered care model to guide conversations, role plays and didactic methods designed to help patients understand and enhance protective behaviors for potential sexual health risks. Over 500 non-pregnant female patients (70% Latino) between the ages 13 and 19 participated during 2012. Health educator and teen assessments have shown substantial improvements in confidence levels and practices for safer sex (e.g., condom use, abstinence). The presentation will examine program findings and key recommendations for effective patient-centered reproductive health for adolescent patients in community health centers.