Improving Family Planning Services to Rural Adolescents

A longitudinal study conducted among young women and family planning service providers in 3 rural New York counties underscored the need to pay attention to individual differences among the clients served. Barriers to family planning acceptance in these counties included factors such as poor public transportation, long distances to clinic, and no telephone in many households that the urban population does not confront. The 900 young women in the sample were categorized as unserved, underserved, adequately served, or well served with regard to their family planning needs. A comparison of psychometric and survey data from these respondents indicated that clinic clients tended to be unmarried, to have a higher personal income, and have fewer children than their counterparts who were contraceptive nonusers. In addition, nonacceptors who completed the Future Events Test expected more positive events never to happen and made less use of planning for the future than the young women who were clients of the family planning clinic in their county. Although qualitative evaluation and participant-observation revealed significant differences between the 3 counties in terms of their family planning services, the distribution of women in the 4 categories did not differ among counties. Overall, these findings indicate that personality characteristics rather than situational variables are the best predictors of success or failure in taking steps to avoid unwanted pregnancy. For young women who are assessed at intake as lacking sufficient motivation to follow through on contraception, clinic personnel should develop an individualized plan aimed at providing education and raising self-esteem and optimism about control over future events.