Table 2.
Prevalence and change in the number and percentage of participating health centers (n = 48) implementing evidence-based clinical practices, by practice, 2012 and 2013
| Specific evidence-based clinical practice (EBCP) | Health centers implementing evidence-based clinical practices |
||
|---|---|---|---|
| 2012; number (%) | 2013; number (%) | Change from 2012 to 2013; number (%) |
|
| Contraceptive access | |||
| Appointments are available during the weekend | 14 (29) | 20 (42) | +6(13) |
| Sexual health assessment taken/updated at every visit | 39 (81) | 41 (85) | +2 (4) |
| Wide range of Contraception is available (via prescription and/or dispensed on-site) | 33 (69) | 35 (73) | +2 (4) |
| Appointments are available after school hours | 46 (96) | 47 (98) | +1 (2) |
| Prescribe hormonal contraception to adolescent females without prerequisite exams or testing (i.e., without first requiring any of the following: Pap smear, pelvic examination, breast examination, or STD testing). | 1 (2) | 1 (2) | 0 (0) |
| Same-day or walk-in appointments are available for adolescents | 47 (98) | 47 (98) | 0 (0) |
| Hormonal contraception or IUD is available at every visit that the adolescent makes to the clinical provider (e.g., urgent, preventive, school-health, sports physical, pregnancy testing, emergency contraception (EC), STD testing, HIV testing etc.) | 44(92) | 37 (77) | −7 (−15) |
| Quick Start method for initiation of hormonal contraception and IUD | |||
| Quick Start initiation of hormonal contraception after an adolescent client has had a negative pregnancy test | 43 (90) | 47 (98) | +4 (8) |
| The option of having an IUD inserted using the Quick Start method | 25 (52) | 28 (58) | +3 (6) |
| Quick Start initiation of hormonal contraception when an adolescent client is provided with EC where a pregnancy test is negative | 42 (88) | 44 (92) | +2 (4) |
| Hormonal contraception is initiated utilizing the Quick Start method | 45 (94) | 46 (96) | +1 (2) |
| EC | |||
| EC is provided to male adolescents for future use (advance provision) | 19 (40) | 20 (42) | +1 (2) |
| EC is available (i.e., dispensed on-site, dispensed with prescription) | 46 (96) | 46 (96) | 0 (0) |
| EC is provided to female adolescents for future use (advance provision) | 34(71) | 34(71) | 0 (0) |
| Cervical cancer screening | |||
| Adhere to current cervical cancer screening (Pap smear) guidelines for adolescent females (initiate Pap screening at age 21 years) | 46 (96) | 47 (98) | +1 (2) |
| STD and HIV testing | |||
| Expedited patient-delivered partner therapy (EPT) is available as an option for the treatment of uncomplicated chlamydial infection | 30 (63) | 33 (69) | +3 (6) |
| Chlamydia screening is provided to all adolescent females at least annually or based on diagnostic criteria, consistent with USPSTF and CDC recommendations | 48 (100) | 48(100) | 0 (0) |
| Chlamydia screening via urine is available for adolescent females | 48 (100) | 48(100) | 0 (0) |
| Chlamydia screening via urine screening is available for adolescent males | 45 (94) | 45 (94) | 0 (0) |
| Gonorrhea screening is available for both adolescent females and males | 47 (98) | 47 (98) | 0 (0) |
| Rapid HIV testing is available for adolescent females and males in accord with CDC recommendations | 33 (68) | 28 (58) | −5 (−10) |
| Cost, confidentiality, and consent | |||
| Low- or no-cost contraceptive and reproductive health care services are provided to adolescents | 43 (90) | 47 (98) | +4 (8) |
| Confidential contraceptive and reproductive health care is available to adolescents without need for parental or caregiver consent | 46 (96) | 46 (96) | 0 (0) |
| Infrastructure | |||
| Systems in place to facilitate billing third-party payers for contraceptive and reproductive health care services provided | 41 (85) | 46 (96) | +5 (10) |
| Utilize electronic medical records | 43 (90) | 43 (90) | 0 (0) |
| Participate in the federal 340B Drug Discount Purchasing Program | 40 (83) | 39(81) | −1 (−2) |
| Environment | |||
| Counseling area available that provides both visual and auditoryprivacy | 34(71) | 38 (80) | +4 (8) |
| Examination room available that provides visual and auditory privacy | 36 (75) | 38 (80) | +2 (4) |
| Display information (pamphlets, posters, flyers, fact sheets) on issues related to adolescent sexual and reproductive health (e.g., confidentiality, cost, what services are available to adolescents) | 31 (65) | 33 (69) | +2 (4) |
| Provide brief evidence-based or evidence-informed video or otherinterventions designed for adolescents (e.g., “What Could You Do?”) | 8(17) | 9(19) | +1 (2) |
| Have teen-focused magazines or posters on the walls | 35 (73) | 35 (73) | 0 (0) |
CDC = Centers for Disease Control and Prevention; IUD = intrauterine devices; STD = sexually transmitted diseases; USPSTF = U.S. Preventiv