title: Privacy and Confidentiality Practices In Adolescent Family Planning Care At Federally Qualified Health Centers.
abstract: BACKGROUND
  The confidentiality of family planning services remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in settings designed for teenagers who are medically underserved, including federally qualified health centers (FQHCs).
  
  
  METHODS
  A sample of 423 FQHCs surveyed in 2011 provided information on their use of five selected privacy and confidentiality practices, which were examined separately and combined into an index. Regression modeling was used to assess whether various state policies and organizational characteristics were associated with FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted to provide additional contextual information.
  
  
  RESULTS
  Among FQHCs reporting on confidentiality, most reported providing written or verbal information regarding adolescents' rights to confidential care (81%) and limiting access to family planning and medical records to protect adolescents' confidentiality (84%). Far fewer reported maintaining separate medical records for family planning (10%), using a security block on electronic medical records to prevent disclosures (43%) or using separate contact information for communications regarding family planning services (50%). Index scores were higher among FQHCs that received Title X funding than among those that did not (coefficient, 0.70) and among FQHCs with the largest patient volumes than among those with the smallest caseloads (0.43). Case studies highlighted how a lack of guidelines and providers' confusion over relevant laws present a challenge in offering confidential care to adolescents.
  
  
  CONCLUSIONS
  The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations.
authors.affiliation: Department of Health, Educational Administration and Movement Studies, Central Washington University, Ellensburg, WA. tbeeson@cwu.edu.
authors.forename: Tishra
authors.initials: T
authors.lastname: Beeson
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Mead
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Susan
authors.initials: S
authors.lastname: Wood
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Debora Goetz
authors.initials: DG
authors.lastname: Goldberg
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Peter
authors.initials: P
authors.lastname: Shin
authors.affiliation: Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Sara
authors.initials: S
authors.lastname: Rosenbaum
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health / Q000706:statistics & numerical data; D016497:Adolescent Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D003219:Confidentiality; D016656:Family Planning Policy; D005193:Family Planning Services / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D018907:Privacy; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D014481:United States