Where have all the teens gone? Decline in adolescent female participation in California's family planning program following cuts in outreach funding

California’s family planning program, Family Planning, Access, Care and Treatment (Family PACT), is an important source of family planning and reproductive health services for adults and adolescents in California. Between fiscal years 2004-05 and 2010-11, the number of female adolescents served by Family PACT decreased from 260,606 to 240,914 (-8%). This study examined whether reductions in state funding for Teen Pregnancy Prevention (TPP) programs, including prevention education, youth development, and outreach programs to connect adolescents with family planning and reproductive health services, contributed to this decline. The study used a mixed-method approach, combining mixed-effects regression models of Family PACT administrative data and other secondary sources with qualitative interviews with Family PACT providers. Compared to providers with no TPP involvement, results indicated that past TPP grantees and partners served significantly more adolescent female Family PACT clients, but they also experienced a steeper decline in this client subgroup over the study period. In qualitative interviews, Family PACT providers described drastically reducing their marketing and outreach to adolescents, particularly education efforts in schools, following the funding cuts. Scaling back marketing and outreach efforts contributed to the decline in adolescent Family PACT participation, because adolescents had less knowledge of family planning services and the Family PACT Program. Study results point to the need to continue to enhance marketing, outreach, and education efforts in order to increase adolescents’ knowledge and utilization of family planning services available through Family PACT.