Return for follow-up care and contraceptive continuation among adolescents
Balassone, M.L.
Journal of Adolescent Research 4(3): 356-370
1989
ISSN/ISBN: 0743-5584 PMID: 12283022 DOI: 10.1177/074355488943006Document Number: 368346
Family planning clinic personnel have reported high rates of contraceptive discontinuation among adolescent clients and the majority of these teenagers fail to return for their 3-month and annual reproductive health examinations. To learn more about the characteristics of adolescents unlikely to return to family planning clinics for follow-up care, the medical history records of 218 adolescent oral contraceptive acceptors at 6 clinic sites in California's Bay Area were randomly selected from a sampling frame of all females 17 years of age and younger who received their initial OC prescription during the 22-month study period. The average age of study respondents was 15.4 years; 48% were black, 39% were white, 8% were Hispanic, and 4% were Asian. The average age at 1st intercourse was 14.3 years; only 9% of study subjects obtained contraception before becoming sexually active. Over half (110 adolescents) of the sample failed to return to the family planning clinic for follow-up care. Both bivariate and multivariate analyses were conducted to determine the correlates of nonreturn. There were no significant differences between adolescents were returned to the clinic and those who did not in terms of age, ethnicity, clinic where served, or other sources of medical care. In terms of reproductive history, adolescents who started having intercourse at younger ages and those who waited longest after the onset of intercourse to seek contraception were least likely to return to the clinic. 75% of the adolescents who had a sexually transmitted disease at the time of the initial visit did not return. Other factors significantly correlated with nonreturn for follow-up were irregular menstrual periods, referral for additional medical tests, failure to have obtained a pap smear in the year prior to the initial visit, and the presence of general health problems such as asthma.