Guttmacher Institute, Research Division, New York, NY 10038, USA.
J Adolesc Health. 2013 Mar;52(3):284-92. doi: 10.1016/j.jadohealth.2012.10.276. Epub 2012 Dec 12.
Increased use of contraceptive services, including long-acting reversible contraceptives (LARCs), among sexually active teens and young adults could significantly reduce unintended pregnancy. Objectives were to describe youth-friendly contraceptive services (including LARC) available to teens and young adults at U.S. publicly funded family planning facilities.
Between April and September 2011, center directors at a nationally representative sample of 1,196 U.S. publicly funded family planning facilities were surveyed to assess accessibility and provision of contraceptive services for teens and young adults; 584 (52%) responded.
Facilities were accessible to young clients in several ways, including not requiring scheduled appointments for method refills (67%) and having flexible hours (64%). Most facilities provided outreach and/or education to young people (70%), and 27% used social network media to do this. Most facilities took steps to ensure confidentiality for young clients. These youth-friendly practices were more common at Planned Parenthood, Title X, and reproductive health focused facilities than at other facilities. Long-acting reversible contraceptive methods were regularly discussed with younger clients at less than half the facilities. Youth-friendly sites had increased rates of LARC provision among younger clients. The most common challenges to providing contraceptive and LARC services to younger clients were the costs of LARC methods (60%), inconvenient clinic hours (51%), staff concerns about intrauterine device (IUD) use among teens (47%), and limited training on implant insertion (47%).
Improving the ability of family planning facilities to provide youth-friendly contraceptive and LARC-specific methods to younger clients may increase the use of highly effective contraception in this population.
增加包括长效可逆避孕措施（LARC）在内的避孕服务在活跃青少年和年轻人群中的使用率，可显著降低非意愿妊娠。本研究旨在描述美国公共资助计划生育机构为青少年和年轻人群提供的以青少年为中心的避孕服务（包括 LARC）。
2011 年 4 月至 9 月，对全国具有代表性的 1196 家美国公共资助计划生育机构的中心主任进行了调查，以评估这些机构为青少年和年轻人群提供避孕服务的可及性和服务提供情况；584 名（52%）中心主任做出了回应。
多家机构以多种方式为年轻客户提供服务，包括不需要预约即可续领避孕措施（67%）和提供灵活的工作时间（64%）。大多数机构为年轻人提供外展和/或教育服务（70%），其中 27%利用社交网络媒体开展此项工作。大多数机构都采取措施确保年轻客户的隐私。在计划生育组织、计划生育项目和生殖健康重点机构中，这些以青少年为中心的做法比其他机构更为常见。不到一半的机构定期与年轻客户讨论长效可逆避孕方法。提供青少年友好服务的机构为年轻客户提供 LARC 的比例更高。为年轻客户提供避孕和 LARC 服务最常见的挑战是 LARC 方法的费用（60%）、诊所工作时间不方便（51%）、工作人员对青少年使用宫内节育器（IUD）的担忧（47%），以及对植入物插入术的培训有限（47%）。
提高计划生育机构为年轻客户提供以青少年为中心的避孕和 LARC 特定方法的能力，可能会增加该人群中高度有效的避孕方法的使用。
