title: Quality, mainstream services with proactive and targeted outreach: a model of contraceptive service provision for young people.
abstract: BACKGROUND
  High teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and competition for resources between two services limits the opening hours of both. In this way access by clients of all ages may be reduced. We have piloted an alternative approach. We provide quality mainstream services (open to clients of all ages) with extended hours and no appointment necessary. This is combined with targeted outreach to facilitate access by the under-25s. The outreach programme includes the development of close links between the clinic and local schools, youth services, social services and voluntary sector organisations. This paper presents one part of the evaluation of this service.
  
  
  METHODS
  Patients registering in the 6 months before and 18 months after the development of the new service completed an anonymous questionnaire. This collected demographic details and data on their source of information about the service.
  
  
  RESULTS
  The number of clients of all age groups registering at the new service in the first year doubled. The number of new users aged under 16 years increased by 12-fold in the first 18 months. The number of young people citing a school sex education class as their source of information about the clinic increased by more than five-fold.
  
  
  CONCLUSIONS
  This model of contraceptive service provision significantly increases service access by young people. It represents an effective alternative to dedicated services for young people.
authors.affiliation: Department of Reproductive Health, Community Health South London NHS Trust, St Giles Hospital, London, UK.
authors.forename: Paula
authors.initials: P
authors.lastname: Baraitser
authors.forename: Rachael
authors.initials: R
authors.lastname: Fettiplace
authors.forename: Frances
authors.initials: F
authors.lastname: Dolan
authors.forename: Helen
authors.initials: H
authors.lastname: Massil
authors.forename: Sarah
authors.initials: S
authors.lastname: Cowley
mesh_terms: D000293:Adolescent; D000328:Adult; D003159:Community-Institutional Relations; D005193:Family Planning Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008131:London; D008389:Marketing of Health Services; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*