title: The effect of an educational approach to pregnancy prevention among high-risk early and late adolescents.
abstract: OBJECTIVE
  To evaluate a novel approach to adolescent pregnancy prevention through scheduled educational clinic visits, focusing to retain patients within the clinic system.
  
  
  METHODS
  This is a retrospective chart review conducted at the Center for Adolescent Pregnancy Prevention, a privately funded clinic located in an urban setting serving only adolescents and young adults. Subjects included adolescent patients aged 11-18 years who were seen between January 2007 and December 2010. The primary outcomes studied were 12- and 24-month continuation rates of birth control options, total length of follow-up, time until gaps in follow-up, and any incident pregnancies. Results were stratified based on age at initial visit: early adolescents (aged 11-15 years) or late adolescents (aged 16-18 years).
  
  
  RESULTS
  There were 121 patients who met inclusion and had more than one visit. There were seven incident pregnancies over the study period, all in the late adolescent group. The relative risk of pregnancy among those with a gap in follow-up of >12 months compared with those without a gap was 4.63 (95% confidence interval [CI] 1.1-19.4). The early adolescents had a greater rate of continuation of birth control at 12 months compared with late adolescents (66.6% vs. 42.2%, relative risk [RR] 1.57, 95% CI 1.12-2.20) and had higher rates of continuation at 24 months (41.6% vs. 18.3%, RR 2.27, 95% CI 1.25-4.11).
  
  
  CONCLUSIONS
  The educational approach at Center for Adolescent Pregnancy Prevention may decrease adolescent pregnancy among high-risk adolescents that stay within the clinic system. This educational model may be more effective for early adolescents than late adolescent patients.
authors.affiliation: Department of Obstetrics and Gynecology, Marshall University, Huntington, West Virginia; University of Louisville, School of Public Health and Information Sciences, Louisville, Kentucky. Electronic address: yoost@marshall.edu.
authors.forename: Jennie L
authors.initials: JL
authors.lastname: Yoost
authors.affiliation: Kosair Children's Gynecology Specialists, Louisville, Kentucky.
authors.forename: Susan Paige
authors.initials: SP
authors.lastname: Hertweck
authors.affiliation: Department of Obstetrics and Gynecology, University of Louisville, Louisville, Kentucky.
authors.forename: Susan N
authors.initials: SN
authors.lastname: Barnett
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000554:Ambulatory Care Facilities; D002648:Child; D015331:Cohort Studies; D003267:Contraception / Q000379:methods*; D005260:Female; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000458:organization & administration*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D049168:Pregnancy, Unplanned; D015995:Prevalence; D011322:Primary Prevention / Q000458:organization & administration; D012189:Retrospective Studies; D018570:Risk Assessment; D012736:Sex Education / Q000458:organization & administration; D014481:United States / Q000453:epidemiology; D014505:Urban Population
keywords: Adolescent pregnancy; Contraception continuation; Contraception education; Pregnancy prevention