Meeting the Reproductive Health Care Needs ofAdolescents: California’s Family Planning Access,Care, and Treatment Program
CLAIRE D. BRINDIS, Dr.P.H., LORI LLEWELYN, M.P.P., KATE MARIE, M.P.A.,MAYA BLUM, M.P.H., ANTONIA BIGGS, Ph.D., AND CATHERINE MATERNOWSKA, Ph.D.
To examine the effect of the California Officeof Family Planning’s Family Access, Care, and TreatmentProgram (Family PACT), which was established in 1997to provide comprehensive, reproductive health servicesfor low-income adolescents and adults. Program evalua-tion was used to measure access to services, develop aprofile of users, identify service utilization patterns, andassess the sensitivity of the health care system to theneeds of adolescents.
Data sources include baseline data on Cali-fornia’s previously established family planning services,enrollment, and claims data for the first 4 years of FamilyPACT, client exit interviews, and on-site observations.
Adolescents represented 21% of all clientsserved by Family PACT in fiscal year 2000–2001 (FY2000–2001). Adolescent clients served increased from100,000 in FY 1995–1996 to more than 260,000 in FY2000–2001(161% increase). The proportion of males hasincreased from 1% to 11%. In FY 2000–2001, Hispanicscomprised 50% of adolescent clients, followed by 32%white, 9% African-American, and 6% Asian, Filipino, orPacific Islander. Over one-half were aged 18 or 19 years,42% were aged 15 to 17 years, and 5% were aged youngerthan 15 years. Contraceptive methods most often dis-pensed were barrier methods (55% for females, 72% formales), oral contraceptives (44%), contraceptive injec-tions (16%), and emergency contraceptives (7%); 57%received sexually transmitted infection screening.
By linking eligibility determination tothe delivery of services, removing cost barriers, increas-ing the numbers and types of providers offering publiclyfunded services, and ensuring confidentiality, greaternumbers of adolescents obtained needed reproductivehealth care, thus ensuring an opportunity to reduceunintended pregnancies and sexually transmittedinfections. ©
Society for Adolescent Medicine, 2003
Adolescent reproductive health servicesConfidentialityPublicly funded family planning services
Over the past decade, the United States has experi-enced rapid declines in adolescent pregnancy, reach-ing its lowest rates since initially recorded in 1975.This decline was from 117 in 1985 to 94 pregnanciesper 1000 females aged 15 to 19 years in 1997, repre-senting a 19% reduction.A parallel trend has beendocumented for the U.S. teen birth rate, which in-creased from 51.0 births per 1000 teens in 1985 to 62.1in 1991.However, throughout the 1990s, the teenbirth rate declined steadily, falling to a record low of45.9 births (preliminary data) per 1000 teens in 2001.Although the United States continues to have oneof the highest adolescent pregnancy rates comparedwith those of other industrialized countries, severalsignificant factors appear to have contributed to thedecline in teenage pregnancy and births: delayedsexual activity, more conservative attitudes among
From the Center for Reproductive Health Research and PolicyStudies, University of California, San Francisco, CaliforniaAddress correspondence to: Claire D. Brindis, Dr.P.H., University of California San Francisco, 3333 California Street, Suite 265, San Fran-cisco, CA 94143-0936.Manuscript accepted February 19, 2003.
JOURNAL OF ADOLESCENT HEALTH 2003;32S:79–90
© Society for Adolescent Medicine, 2003 1054-139X/03/$–see front matterPublished by Elsevier Inc., 360 Park Avenue South, New York, NY 10010 doi:10.1016/S1054-139X(03)00065-X