New York City Department of Health and Mental Hygiene, Division of Family and Child Health, Office of School Health, Queens, New York.
New York City Department of Health and Mental Hygiene, New York City Teens Connection, Bronx Neighborhood Health Action Center/Center for Health Equity, Bronx, New York.
J Adolesc Health. 2019 Mar;64(3):376-381. doi: 10.1016/j.jadohealth.2018.09.020. Epub 2018 Dec 1.
Inequitable access to quality adolescent sexual and reproductive health (ASRH) care may contribute to the high rate of teen pregnancy in the Bronx, New York. Bronx Teens Connection (BxTC), a community-wide intervention, sought to increase the number of ASRH best practices implemented and the number of females 12-19 years old receiving services by health centers in the Bronx.
To promote best practices, BxTC provided training and technical assistance to partnering health centers from 2011 to 2014. Health center staff completed a 26-item survey annually to document clinic practices and service utilization. Significance of changes was assessed with paired t tests.
BxTC provided 285 hours of training and technical assistance to 12 partnering health centers. Eight health centers consistently completed the survey. Of the possible 31 ASRH best practices, the average number implemented increased from 23 in 2011 to 28 in 2014. Increases in unduplicated female adolescent patients were observed among Hispanics/Latinas (p = .026) and all females aged 15-17 (p = .035). Contraceptive coverage reported by six of the eight health centers increased among Hispanic/Latinas (32%-55%, p = .006), patients ages 15-17 (33%-53%, p = .005), and patients 18-19 (38%-56%, p = .036). The total number of hormonal implants provided to teens increased from two in 2011 to 173 in 2014.
Other jurisdictions may consider prioritizing clinical linkages in order to improve ASRH outcomes by supporting best practices and expanding access to services in the most disinvested neighborhoods.
在纽约布朗克斯区，由于获得优质青少年性健康和生殖健康（ASRH）服务的机会不平等，青少年怀孕率居高不下。Bronx Teens Connection（BxTC）是一项社区范围的干预措施，旨在增加布朗克斯区各健康中心实施 ASRH 最佳实践的数量，并增加接受服务的 12-19 岁女性人数。
为了推广最佳实践，BxTC 于 2011 年至 2014 年期间为合作健康中心提供培训和技术援助。健康中心工作人员每年完成一份 26 项的调查，记录诊所的做法和服务的利用情况。使用配对 t 检验评估变化的显著性。
BxTC 为 12 家合作健康中心提供了 285 小时的培训和技术援助。有 8 家健康中心始终完成了调查。在 31 项 ASRH 最佳实践中，实施的平均数量从 2011 年的 23 项增加到 2014 年的 28 项。在西班牙裔/拉丁裔（p=0.026）和所有 15-17 岁的女性中，接受独特的青少年女患者人数有所增加。在 8 家健康中心中，有 6 家报告的西班牙裔/拉丁裔青少年（32%-55%，p=0.006）、15-17 岁（33%-53%，p=0.005）和 18-19 岁（38%-56%，p=0.036）的避孕药具覆盖率有所增加。向青少年提供的激素植入物总数从 2011 年的 2 个增加到 2014 年的 173 个。
其他司法管辖区可能会考虑优先建立临床联系，以通过支持最佳实践和扩大在投资最少的社区获得服务的机会，来改善 ASRH 结果。
