Collaborative Model for Maximizing Health Centers' Impact on Teen Contraceptive Uptake

Nationally and in many localities, teen pregnancy rates remain higher than targets, and are disparately high in certain areas. In New York City (NYC), 86% of teen pregnancies are unintended, and reported use of hormonal contraception is low in neighborhoods with the highest teen pregnancy rates. Reported condom use is high, but so are STI rates; condom use may be overstated, inconsistent, and/or incorrect. The NYC Department of Health and Mental Hygiene (DOHMH) promotes use of both condoms and another effective method of contraception by heterosexually active teens not seeking pregnancy. Ensuring access to hormonal contraception at community health centers is advances this strategy. The NYC Healthy Teens Initiative (HTI), a partnership between NYC DOHMH and select community based health centers to increase access to contraception for teens, promotes best practices in contraceptive care for teens. HTI uses a collaborative learning model for quality improvement, the first of its kind relating to contraceptive services, and was successful in producing targeted improvements. This model, and the lessons learned about its strengths and limitations, will be of interest to other jurisdictions aiming to improve clinical sexual health services for teens. We will describe the HTI model and content, emphasizing how it might be used or adapted in different settings. We will review best practices in the design and delivery of reproductive health services with a focus on using existing resources. Participants will be coached on practical aspects of implementing a quality improvement collaborative such as setting goals, recruiting partners, developing teams, and using data to assess baseline and progress. During the workshop, tools developed as part of HTI will be shared for use or adaptation by other agencies. We will discuss factors contributing to successful quality improvement, as well as barriers encountered, using “case study” examples.