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青少年准入和质量倡议:改善公共资助健康中心青少年生殖健康的最佳实践。

The Teen Access and Quality Initiative: Improving Adolescent Reproductive Health Best Practices in Publicly Funded Health Centers.

机构信息

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA.

Cicatelli Associates Inc. (CAI), New York, NY, USA.

出版信息

J Community Health. 2020 Jun;45(3):615-625. doi: 10.1007/s10900-019-00781-z.

Abstract

Quality adolescent sexual and reproductive health (ASRH) services play an important role in supporting the overall health and well-being of adolescents. Improving access to this care can help reduce unintended pregnancies, sexually transmitted diseases (STDs), and human immunodeficiency virus (HIV) infection and their associated consequences, as well as promote health equity. The Centers for Disease Control and Prevention funded three grantees to implement a clinic-based ASRH quality improvement initiative complimented by activities to strengthen systems to refer and link youth to ASRH services. The purpose of this study is to describe the initiative and baseline assessment results of ASRH best practice implementation in participating health centers. The assessment found common use of the following practices: STD/HIV screening, education on abstinence and the use of dual protection, and activities to increase accessibility (e.g., offering after-school hours and walk-in and same-day appointments). The following practices were used less frequently: provider training for Long-Acting Reversible Contraception (LARC) insertion and removal, LARC availability, same-day provision of all contraceptive methods, and consistent sharing of information about confidentiality and minors' rights with adolescent clients. This study describes the types of training and technical assistance being implemented at each health center and discusses implications for future programming.

摘要

优质青少年性与生殖健康(ASRH)服务在支持青少年整体健康和福祉方面发挥着重要作用。改善对这些服务的获取途径,有助于减少意外怀孕、性传播疾病(STD)、人类免疫缺陷病毒(HIV)感染及其相关后果,并促进健康公平。疾病控制与预防中心资助了三个受赠方,以实施一项基于诊所的 ASRH 质量改进举措,并辅以加强转介和将青少年与 ASRH 服务联系起来的系统的活动。本研究旨在描述参与健康中心的 ASRH 最佳实践实施情况的倡议和基线评估结果。评估发现,以下实践的使用较为普遍:STD/HIV 筛查、禁欲和双重保护使用方面的教育,以及增加可及性的活动(例如,提供课后时间、随到随诊和当日预约)。以下实践的使用频率较低:长效可逆避孕(LARC)插入和取出的提供者培训、LARC 的供应、当日提供所有避孕方法,以及与青少年客户一致分享有关保密性和未成年人权利的信息。本研究描述了在每个健康中心实施的培训和技术援助类型,并讨论了对未来规划的影响。

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