title: Rural-Urban Differences in Awareness and Use of Family Planning Services Among Adolescent Women in California.
abstract: OBJECTIVE
  The purpose of this study was to compare awareness and use of family planning services by rural and urban program site among a sample of adolescent women before participation in the federal Personal Responsibility Education Program in California.
  
  
  METHODS
  We conducted a secondary analysis of survey data collected from youth before participation in California's Personal Responsibility Education Program. Bivariate and multivariate analyses were conducted for a sample of 4,614 females ages 14-18 years to compare awareness and use of family planning services between participants at rural and urban program sites, controlling for the program setting and participant demographic, sexual, and reproductive characteristics.
  
  
  RESULTS
  Overall, 61% of participants had heard of a family planning provider in their community, and 24% had visited a family planning provider. Awareness and use of family planning services were lower among rural participants than urban participants. After adjusting for the program setting and participant characteristics, rural participants were less likely to know about a family planning provider in their community (odds ratio, .64; 95% confidence interval, .50-.81) or receive family planning services (odds ratio, .76; 95% confidence interval, .58-.99) than urban participants.
  
  
  CONCLUSIONS
  Findings suggest that adolescents in rural areas face greater barriers to accessing family planning services than adolescents in urban areas. Targeted efforts to increase awareness and use of family planning services among adolescents in rural areas and among other underserved populations are needed.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies and Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California. Electronic address: jennifer.yarger@ucsf.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Yarger
authors.affiliation: Philip R. Lee Institute for Health Policy Studies and Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California.
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Decker
authors.affiliation: Maternal, Child, and Adolescent Health Division, California Department of Public Health, Sacramento, California.
authors.forename: Mary I
authors.initials: MI
authors.lastname: Campa
authors.affiliation: Philip R. Lee Institute for Health Policy Studies and Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Adolescent and Young Adult Health National Resource Center, University of California, San Francisco, San Francisco, California.
authors.forename: Claire D
authors.initials: CD
authors.lastname: Brindis
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002140:California; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000706:statistics & numerical data*; D012423:Rural Health / Q000706:statistics & numerical data; D012736:Sex Education / Q000379:methods / Q000458:organization & administration*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014504:Urban Health / Q000706:statistics & numerical data
keywords: Adolescent; Awareness; Family planning services; Rural; Urban