Service integration and teen friendliness in practice: a program assessment of sexual and reproductive health services for adolescents.
OBJECTIVE
To aid front-line program administrators and providers in adopting national reproductive health recommendations, this exploratory case study examines the implementation of service integration and teen friendliness as strategies to improve adolescent sexual and reproductive health.


METHODS
The project team conducted semi-structured interviews with administrators, providers, and adolescent clients from 10 clinical adolescent sexual and reproductive health service agencies in Alameda County, California. Programs were placed into a topology of integrated service delivery models. The teen friendliness of each program was assessed. Spearman rank correlations were calculated to evaluate the relationship between integration and teen friendliness.


RESULTS
Clinical programs exhibited a great range of service delivery models within the integration topology. Human immunodeficiency virus (HIV) counseling and testing services were poorly integrated into clinic services. Teen friendliness and integration showed a negative, but not statistically significant, correlation (R = -.45, p = .19).


CONCLUSIONS
Programs have made different levels of commitment to service integration or teen friendliness policies. Lessons learned through the integration of sexually transmitted disease (STD) and family planning services may assist efforts to better integrate HIV services for adolescents. Further work to elucidate the relationship between integration and teen friendliness is needed. Periodic reviews can ensure that recommended clinical guidelines, specifically annual risk assessment, are being met, as well as identifying achievable next steps to improve adolescent sexual and reproductive health service delivery.
Brindis
Claire D
CD
Division of Adolescent Medicine, Department of Pediatrics, Institute for Health Policy Studies, University of California, San Francisco School of Medicine, San Francisco, California, USA. brindis@itsa.ucsf.edu
Loo
Virginia S
VS
Adler
Nancy E
NE
Bolan
Gail A
GA
Wasserheit
Judith N
JN
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000592:standards; D003376:Counseling; D019033:Delivery of Health Care, Integrated; D005260:Female; D033062:Friends; D006291:Health Policy; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control; D011369:Professional-Patient Relations; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control