Addressing Organizational Barriers to Adolescent Access to High-Quality, Low-Cost, Confidential Sexual and Reproductive Health Services in a Community Health Center

Abstract

Adolescents face a number of barriers to accessing high-quality, confidential sexual and reproductive health (SRH) services. Although federally qualified health centers (FQHCs), a type of community health center (CHC), are a critical source of health care for medically underserved adolescents, they often lack the capacity and resources to provide specialized SRH services to adolescents. In this article, we describe the development and implementation of an initiative aimed at improving an FQHC’s capacity to provide high-quality confidential SRH services to adolescents. For this initiative, a team of clinical and quality improvement staff developed a set of six strategies to improve adolescent SRH services at an FQHC: (1) building community relationships and galvanizing internal organizational support to improve adolescent access to confidential SRH services, (2) developing a long-acting reversible contraception (LARC) program, (3) training clinic staff on SRH and adolescent health topics, (4) adapting the adolescent patient workflow to improve SRH service delivery during appointments, (5) updating and implementing a universal adolescent health assessment tool, and (6) developing billing and registration policies that allow adolescents to receive confidential SRH services. We identified several factors that we believe were key to the successful implementation of our approach in other CHC settings, including encouraging cross-sector collaboration and community focus, providing training as a tool to engage and empower staff as agents of change, involving interdisciplinary staff, piloting on a small scale, and establishing consistent meetings with a clinic champion and improvement team.

A Mixed Methods Study of Contraceptive Counseling and Care at a Federally Qualified Health Center in Maryland

“…7,8 Federally qualified health centers (FQHCs) are designed to meet the primary healthcare needs of socially disadvantaged populations. 8,9 In these and other clinic settings, patients consistently report a desire to receive reproductive health services in the same setting as their other essential primary care services. 10,11 Within FQHCs and in other primary care settings, provider perspectives regarding the challenges in the delivery of high-quality contraceptive care integrated with other primary care services, have been documented.…”

Impact of Check It: A Novel Community-Based Chlamydia Screening and Expedited Treatment Program for Young Black Men

“…One of the clear barriers to screening is that young men are less likely than young women to access health care 18 . Adolescents in general 19 and young Black men in particular 20 face many barriers to accessing health care; thus, there is a need to conduct screening in the community. Prior work has shown that venue-based screening of men in high-prevalence areas has yielded high rates of infection detection 21,22 .…”