TY - JOUR
T1 - A comparison of contraceptive services for adolescents at school-based versus community health centers in Oregon
AU - Boniface, Emily R.
AU - Rodriguez, Maria I.
AU - Heintzman, John
AU - Knipper, Sarah H.
AU - Jacobs, Rebecca
AU - Darney, Blair G.
N1 - Publisher Copyright:
© 2021 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust.
PY - 2022/2
Y1 - 2022/2
N2 - Objective: To compare Oregon school-based health centers (SBHCs) with community health centers (CHCs) as sources of adolescent contraceptive services. Data sources: Oregon electronic health record data, 2012–2016. Study design: We compared clinic-level counseling rates and long-acting reversible contraception (LARC) provision, adolescent populations served, and visit-level LARC provision time trends. We evaluated adjusted associations between LARC provision and Title X participation by clinic type. Data collection/extraction methods: We used diagnosis and procedure codes to identify contraceptive counseling and provision visits, excluding visits for adolescents not at risk of pregnancy. Principal findings: CHCs were more likely to provide LARC on-site than SBHCs (67.2% vs. 36.4%, respectively). LARC provision increased more at SBHCs (5.8-fold) than CHCs (2-fold) over time. SBHCs provided more counseling visits per clinic (255 vs. 142) and served more young and non-White adolescents than CHCs. The adjusted probability of LARC provision at Title X SBHCs was higher than non-Title X SBHCs (4.4% [3.9–4.9] vs. 1.7% [1.4–2.0]), but there was no significant association at CHCs. Conclusions: In Oregon, CHCs and SBHCs are both important sources of adolescent contraceptive services, and Title X plays a crucial role in SBHCs. Compared with CHCs, SBHCs provided more counseling, showed a larger increase in LARC provision over time, and served more younger and non-White adolescents.
AB - Objective: To compare Oregon school-based health centers (SBHCs) with community health centers (CHCs) as sources of adolescent contraceptive services. Data sources: Oregon electronic health record data, 2012–2016. Study design: We compared clinic-level counseling rates and long-acting reversible contraception (LARC) provision, adolescent populations served, and visit-level LARC provision time trends. We evaluated adjusted associations between LARC provision and Title X participation by clinic type. Data collection/extraction methods: We used diagnosis and procedure codes to identify contraceptive counseling and provision visits, excluding visits for adolescents not at risk of pregnancy. Principal findings: CHCs were more likely to provide LARC on-site than SBHCs (67.2% vs. 36.4%, respectively). LARC provision increased more at SBHCs (5.8-fold) than CHCs (2-fold) over time. SBHCs provided more counseling visits per clinic (255 vs. 142) and served more young and non-White adolescents than CHCs. The adjusted probability of LARC provision at Title X SBHCs was higher than non-Title X SBHCs (4.4% [3.9–4.9] vs. 1.7% [1.4–2.0]), but there was no significant association at CHCs. Conclusions: In Oregon, CHCs and SBHCs are both important sources of adolescent contraceptive services, and Title X plays a crucial role in SBHCs. Compared with CHCs, SBHCs provided more counseling, showed a larger increase in LARC provision over time, and served more younger and non-White adolescents.
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U2 - 10.1111/1475-6773.13889
DO - 10.1111/1475-6773.13889
M3 - Article
C2 - 34624140
AN - SCOPUS:85117779825
SN - 0017-9124
VL - 57
SP - 145
EP - 151
JO - Health Services Research
JF - Health Services Research
IS - 1
ER -