Privacy and Confidentiality Practices Supporting Family Planning Care for Adolescents in Federally-Qualified Health Centers (FQHCs)

PURPOSE: Family planning confidentiality remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in underserved settings. The purpose of this paper is to examine how community health centers provide confidential family planning care to adolescents and understand the barriers that make it difficult to provide confidential family planning in health center settings.

METHODS:  This mixed-methods study employed a 2011 national survey of family planning in community health centers, as well as six in-depth case studies with health centers in varying communities across the U.S. Five common privacy and confidentiality practices related to adolescent family planning were examined both individually and as an aggregate index. Regression modeling was used to determine if state policies and organizational factors influence privacy and confidentiality practices in family planning.

RESULTS: Most health centers reported restrictions on family planning and medical records to protect adolescents' confidentiality (84 percent) and the provision of written or verbal information regarding adolescents' rights to confidential care (81 percent). Far fewer health centers reported maintaining separate medical records for family planning (10 percent) or separate contact information for communications regarding family planning services (50 percent). Health centers receiving Title X funding (p-value < 0.001) and those with medium-to-high patient volumes (p-value = 0.022) exhibited higher aggregate index scores.

CONCLUSIONS: While many health centers employ one or more practice to protect adolescents' privacy and confidentiality, the efforts are varied across organizations. Health centers have an opportunity to enhance their efforts to better serve their adolescent patients.