Tailoring Family Planning Services to the Special Needs of Adolescents:
New Adolescent Approach Protocols

Lynn Cooper Breckenmaker & Laraine Winter, Ph.D.

FOCUS

SUMMARY

This family planning clinic-based intervention was originally developed for teens less than 18 years of age. It is based on the premise that regular contraceptive use by teens can be increased by offering information, social support, and counseling, in addition to health and medical services. Accordingly, the program aims to provide family planning services in a manner that will increase teens' sense of comfort, increase their self-confidence, and reduce any fears that may discourage regular and effective contraception. A key component of the intervention is the Personal Information Form, a one-page questionnaire designed to aid staff in understanding teens' concerns, providing counsel and identifying patients who may be at greatest risk for early pregnancy. To ease teens' anxiety, the first appointment is divided into two visits, with education and counseling provided in the first session and the medical examination (and contraceptive prescription) deferred until the second. The intervention also includes: (1) education in a one-on-one rather than a group setting; (2) use of visual aids; (3) a follow-up visit scheduled six weeks after the initial appointment; and (4) encouragement of participation by family members, partners and friends, while respecting the patient's right to confidential services. A field study was conducted with 1,261 teens attending six family planning clinics. Compared to their peers receiving standard services, program participants showed significantly greater gains in knowledge, contraceptive usage and, significantly fewer pregnancies at the 6- and 12-month follow up assessments.

SUITABLE FOR USE IN

This program is suitable for use in community-, hospital- or school-based family planning clinics.

ORIGINAL INTERVENTION SAMPLE

Age, Gender
The field study involved 1,261 adolescent females, of whom 40% were age 17, 34% age 16, and 16% age 15.

Race/Ethnicity
95% White, 1% African-American , 4% other (mostly Latino).

PROGRAM LENGTH

A six-week period is required for the initial two part visit and a follow-up appointment. Additional visits are scheduled as necessary.

STAFFING REQUIREMENTS/TRAINING

In addition to the regular clinic staff (e.g., gynecologist, nurse practitioner), a counselor-educator is needed to review the Personal Information Form and lead the educational segment of each patient's first visit. All program staff should receive training in adolescent psychology.

   Primary Pregnancy Prevention
   Secondary Pregnancy Prevention
   STD/HIV/AIDS Prevention

ORIGINAL SITE
   School-Based
   Community-Based
   Clinic-Based

APPROACH
   Abstinence
   Behavioral Skills Development
   Community Outreach
   Contraceptive Access
   Contraceptive Education
   Life Option Enhancement
   Self-Efficacy/Self-Esteem
   Sexuality/STD/HIV/AIDS Education

COMPONENTS
   Adult Involvement
   Case Management
   Group Discussion
   Lectures
   Peer Counseling/Instruction
   Public Service Announcements
   Role Play
   Video

   Other
Visual instructional aids (e.g. posters,
pel
vic model)

   

PASHA PROGRAM PACKAGE

The PASHA Program Package for this program includes:

  • PASHA User's Guide
  • New Adolescent Approach Protocols Handbook
  • Personal Information Form
  • A Set of Health Education Brochures and Catalogs
  • A Set of Original Evaluation Instruments
  • Prevention Minimum Evaluation Data Set (PMEDS)
  • Local Evaluator Consultant Network Directory

  • Telephone technical support on implementation and evaluation for 1 year