title: Beyond the Surface: Care Seeking Among Patients Initiating Contraceptive Implant in an Urban Federally Qualified Health Center Network.
abstract: OBJECTIVE
  To describe rates of and reasons for follow-up among adolescents and adults receiving contraceptive implants in a Federally Qualified Health Center (FQHC).
  
  
  METHODS
  Retrospective comparison of patient-initiated implant-related contacts during the 6 months postinsertion among adolescents (110) and adults (154) who had implants placed at a FQHC network.
  
  
  RESULTS
  Forty percent of adolescents and 26% of adults initiated follow-up ( P = .016). Bleeding changes and discussing removal were the most common reasons for follow-up for both groups. Adolescents (5.5%) and adults (9.0%) had similar removal rates ( P = .348). However, among patients who discussed implant removal, adults were more likely to have removals compared with adolescents ( P = .002).
  
  
  CONCLUSIONS
  Other FQHCs may anticipate a similar experience to ours, where adolescents may be more likely than adults to initiate implant-related follow up, with removal rates of less than 10% at 6 months. Further study of physician decision making and patient autonomy regarding implantable contraception removal requests is warranted.
authors: 1 University of Pennsylvania, Philadelphia, PA, USA.
authors: Anita
authors: A
authors: Ravi
authors: 2 Institute for Family Health, New York, NY, USA.
authors: Linda
authors: L
authors: Prine
authors: 3 Reproductive Health Access Project, New York, NY, USA.
authors: Gabrielle
authors: G
authors: deFiebre
authors: 4 Montefiore Medical Center/Albert Einstein Colege of Medicine, Bronx, NY, USA.
authors: Susan E
authors: SE
authors: Rubin
keywords: FQHC; adolescent; community health centers; contraception; implantable contraception; primary care