Adolescent Contraceptive Behavior: The Impact of the Provider and the Structure of Clinic-Based Programs

OBJECTIVE: To characterize general trends in research on the impact of provider variables on adolescent contraceptive behavior and to identify useful frameworks for designing clinic-based programs aimed at reducing unintended adolescent pregnancy. DATA SOURCES: A computerized search of Psychological Abstracts, Sociological Abstracts, and MEDLINE identified English-language articles from 1990 to 1995 on adolescent contraceptive behavior in the United States. All relevant citations within these articles also were examined. METHODS OF STUDY SELECTION: Studies were selected that focused on any aspect of provider characteristics as they relate to adolescent contraceptive behavior. TABULATION, INTEGRATION, AND RESULTS: Based on a conceptual integration of the articles, three general research issues on provider characteristics were identified; 1) the effectiveness of adolescent-based clinic programs and provider variables that discriminate successful versus unsuccessful programs, 2) the effects of parental notification policies on adolescent clinic use, and 3) whether the presence of clinics promotes sexual activity on the part of adolescents. Issues that must be considered in the structuring of provider-based programs include the strategic focus of the program, the target behaviors, the target population, and the structuring of educational materials. CONCLUSION: The effectiveness of adolescent-based clinic programs is mixed. Parental notification of adolescent use of a clinic can, in some cases, decrease the likelihood of clinic use. There is little convincing evidence that the presence of adolescent clinics promotes sexual activity.