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 identi fy useful frameworks for designing clinic-based programs aimed at redu cing unintended adolescent pregnancy. Data Sources: A computerized sea rch of Psychological Abstracts, Sociological Abstracts, and MEDLINE id entified English-language articles from 1990 to 1995 on adolescent con traceptive behavior in the United States. All relevant citations withi n these articles also were examined. Methods of Study Selection: Studi es were selected that focused on any aspect of provider characteristic s as they relate to adolescent contraceptive behavior. Tabulation, Int egration, and Results: Based on a conceptual integration of the articl es, three general research issues on provider characteristics were ide ntified; 1) the effectiveness of adolescent-based clinic programs and provider variables that discriminate successful versus unsuccessful pr ograms, 2) the effects of parental notification policies on adolescent clinic use, and 3) whether the presence of clinics promotes sexual ac tivity on the part of adolescents. Issues that must be considered in t he structuring of provider-based programs include the strategic focus of the program, the target behaviors, the target population, and the s tructuring of educational materials. Conclusion: The effectiveness of adolescent-based clinic programs is mixed. Parental notification of ad olescent use of a clinic can, in some cases, decrease the likelihood o f clinic use. There is little convincing evidence that the presence of adolescent clinics promotes sexual activity.