Preventing Adolescent Pregnancy and STI in Community Health Centers

The eight counties of California’s San Joaquin Valley have a longstanding history of the highest teen pregnancy and STI in the nation. A partnership among two Federally Qualified Health Center (FQHC) systems in SJV was awarded a competitive award to replicate an evidence-based program to prevent unintended pregnancy and STI for sexually active, non-pregnant, 13-19 year-old female patients. This project is among the first to evaluate a large-scale intervention for teen reproductive health in community health centers. Health educators trained in patient-centered care and motivational interviewing provide four personal visits four times over six months. Visits include in-person and video information, refusal skill role-plays, and condom demonstrations. Within 2-years, 1,440 teen patients were enrolled (67% of all eligible). Participants between the ages of 13 and 19 years, 78% Latino, and 58% spoke Spanish at home.  Results from a self-administered survey following each visit indicated that 15% of teens increased in condom use and 22% of teens increased their use of other pregnancy prevention methods. Other improvements included intentions to abstain (8%), asking a partner to use a condom (5%) and satisfaction with talking to their parents about sex (19%). Program findings include strategies to increase teen participation in reproductive health services at FQHCs and recommendations for leveraging the availability of community health centers in poor and isolated regions to improve health equity.