Adolescent Sexual and Reproductive Health Services in Pediatric Primary Care

Abstract

Many pediatric primary care clinics fall short in providing comprehensive sexual and reproductive health services to adolescent patients resulting in missed opportunities for pregnancy prevention, delays in sexually transmitted disease (STD) identification and treatment, poor access to evidence-based care, and increased healthcare costs. This Doctor of Nursing Practice project determined the impact of an evidence based adolescent program designed to expand existing services to comprehensive adolescent healthcare in an offsite, primary care pediatric clinic in a not for profit hospital in an urban Midwest city. The program included reproductive health and STD screening and treatment. The quasi-experimental improvement project with retrospective chart review compared volume of pre and post intervention adolescent patient visits in 2014 and 2016. Results were examined using Chi-Square statistical analysis. Sexual health visits included encounters for contraception, STD testing, and pregnancy testing. During 2016 the post intervention year there was a statistically significant increase in sexual health services compared to 2014, the pre intervention year (p=0.003). Total adolescent health visits increased from 106 in 2014 to 216 in 2016 (p=0.01). This retrospective review found that expanding adolescent sexual health services in primary care positively impacted health outcomes by increasing access to care for adolescents. Findings suggest integration of sexual health services in pediatric clinics increases adolescent healthcare visits, and reduces the number of unplanned teen pregnancies and untreated STDs in the adolescent population.