title: Improving the Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Care Services.
abstract: OBJECTIVE
  The purposes of the study were to describe baseline data in the implementation of evidence-based clinical practices among health center partners as part of a community-wide teen pregnancy prevention initiative and to identify opportunities for health center improvement.
  
  
  METHODS
  Health center partner baseline data were collected in the first year (2011) and before program implementation of a 5-year community-wide teen pregnancy prevention initiative. A needs assessment on health center capacity and implementation of evidence-based clinical practices was administered with 51 health centers partners in 10 communities in the United States with high rates of teen pregnancy.
  
  
  RESULTS
  Health centers reported inconsistent implementation of evidence-based clinical practices in providing reproductive health services to adolescents. Approximately 94.1% offered same-day appointments, 91.1% had infrastructure to reduce cost barriers, 90.2% offered after-school appointments, and 80.4% prescribed hormonal contraception without prerequisite examinations or testing. Approximately three quarters provided visual and audio privacy in examination rooms (76.5%) and counseling areas (74.5%). Fewer offered a wide range of contraceptive methods (67.8%) and took a sexual health history at every visit (54.9%). Only 45.1% reported Quick Start initiation of hormonal contraception, emergency contraception (43.1%), or intrauterine devices (12.5%) were "always" available to adolescents.
  
  
  CONCLUSIONS
  The assessment highlighted opportunities for health center improvement. Strategies to build capacity of health center partners to implement evidence-based clinical practices may lead to accessibility and quality of reproductive health services for adolescents in the funded communities.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: lmromero@cdc.gov.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Romero
authors.affiliation: Cicatelli Associates, Inc. (CAI), New York, New York.
authors.forename: Dawn
authors.initials: D
authors.lastname: Middleton
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Trisha
authors.initials: T
authors.lastname: Mueller
authors.affiliation: Cicatelli Associates, Inc. (CAI), New York, New York.
authors.forename: Lia
authors.initials: L
authors.lastname: Avellino
authors.affiliation: Cicatelli Associates, Inc. (CAI), New York, New York.
authors.forename: Rachel
authors.initials: R
authors.lastname: Hallum-Montes
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D055317:Evidence-Based Practice; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D058996:Quality Improvement; D060728:Reproductive Health; D034121:Reproductive Health Services / Q000592:standards*; D014481:United States; D055815:Young Adult
keywords: Adolescent reproductive health services; Evidence-based clinical practices; Teen pregnancy; Youth-friendly reproductive health services