Assessing access and delivery of adolescent reproductive health services: An evaluation of Year 1 of the Youth First initiative

The communities of Holyoke and Springfield have consistently had some of the highest teen birth rates and disparities among birth rates in Massachusetts. To address this issue, Youth First, a CDC funded, community-wide initiative was initiated in 2010. A critical component of the initiative is to ensure that all young people have access to quality, youth-friendly reproductive health services. Clinics providing reproductive health services present a key opportunity to reach and support adolescents in making healthy-decisions, potentially aiding in the reduction of teen pregnancies. As such, intensive partnerships with six local health clinics have been established.

To evaluate the initiative's effect on outcomes of adolescent access, quality and clinical care for the six engaged clinics, the evaluation team assessed the clinics' existing infrastructure, organizational capacities and clinical practices. A mixed methods approach was used for this evaluation.

In-person structured interviews were conducted with multi-disciplinary teams from each clinic at baseline. Clinics then engaged in a collaborative learning model focused on using continuous quality improvement efforts to increase the numbers of adolescent clients served and provision of contraceptives. One-year post data was collected to ascertain changes in clinics' practices and outcomes. Data was analyzed aggregately, using descriptive statistics for quantitative items and thematic coding for qualitative.

The data presented will include an overview of youth access, contraceptive coverage, referrals to care, youth-friendliness, and evidence-based reproductive health practices. Lessons learned will be useful for evaluators and practitioners working with clinics to enhance quality and delivery of adolescent reproductive health services.