"It Takes Two"...Or does it? Tailoring teen-specific reproductive health services to improve partner communication and increase fertility awareness

Research suggests that addressing issues relevant to the dynamics of the couple relationship, as well as the individual needs of women and men, improves family planning use and protection against sexually transmitted infections. Preliminary analysis of data from research at Tri-City Health Center in Fremont, CA shows a high degree of couple communication about birth control and some male involvement in method selection and use, although women typically make the final decision regarding use of a particular method. When providing reproductive health services to teens, how might providers honor a young woman's autonomy and confidentiality yet also support male involvement? This paper presents results from research testing a simple intervention designed to incorporate a “couple-focused” approach when providing family planning services at a community-based teen clinic. The intervention incorporated select, couple-focused questions during counseling, and included the discussion of educational materials designed to enhance partner communication about sexual and reproductive health. The intervention also included the use of CycleBeads®, a color-coded string of beads used to teach teens about a woman's menstrual cycle and her fertile days in a very concrete way. The intervention was tailored for a teen population, many of whose parents are recent immigrants from Mexico, India, Afghanistan, China and other countries. This paper presents the results of the teen intervention as evidenced by client and provider interviews, mystery client reports, and focus groups; and discusses viable options for eliciting male support and participation in reproductive health services for teens.