The aim of this project was to investigate adolescent perspectives on family planning services at a community-health center, with the intent to inform health center programs aimed at stemming the adolescent pregnancy rate.

This project was cross-sectional and employed mixed methods, including surveys and interviews, for the purposes of quality improvement.

The project was conducted in the obstetrics and gynecology clinic at an urban community health center in Boston.

Twenty adolescent females (age 16-20) who used services at the health center.

Participants were individually interviewed to assess perspectives on family planning services and to identify major influences on methods of pregnancy prevention.

Major themes were categorized into contraceptive usage, reproductive health knowledge, adult influence and communication, barriers to contraceptive care and expectations of a family planning clinic.

All participants were sexually active and 80% had experienced pregnancy. Reproductive health knowledge was variable and in many cases limited. Concern about disapproval was a prominent barrier to going to a clinician for contraception or advice and parents were not often involved in the initial contraception discussion. Other barriers to use of contraception included forgetting to use the methods and fear of side effects.

We identified several potentially modifiable factors, including lack of knowledge, concern for provider disapproval and fear of side effects that may limit effective use of family planning services by adolescents. Further attention should be paid to these factors in designing and improving youth-friendly services in ob-gyn clinics.