Reach out to teens: One agency’s story

Want to see more adolescents at your facility? Planned Parenthood of South Palm Beach and Broward County (PPSPBBC) in Boca Raton, FL, has captured teens’ attention by packaging a comprehensive health screening with a year’s supply of free birth control pills.

Since the agency kicked off the Teen Health Broward program in July 2004 at its Fort Lauderdale, Pembroke Pines, and Tamarac health clinics, a steady stream of teens have been coming in for care, says Carla Shulman, RNC, OGNP, ARNP, LHCRM, vice president of medical services and risk manager for the agency. A $50 fee charged for the health screening covers a check of the heart, lungs, thyroid, and breasts, accompanied by an abdominal assessment, pelvic exam, and Pap smear. Teens also can opt to choose another form of birth control, but have to pay for the alternate selection. Those teens who cannot take the Pill do have to pay for an alternate method.

While the offer of a free year’s worth of birth control pills may attract some teens, the service is not designed to advocate teen sex, she emphasizes.

"This is about making access to health care affordable and providing access to education that is necessary for those teens who choose to become intimate with another human being," Shulman states.

Filling a need

Providing adolescent care is nothing new for the Boca Raton-based agency; it subcontracts under Planned Parenthood of the Palm Beach and Treasure Coast Area to offer Teen Time, a state-funded Title X teen pregnancy prevention program. The Teen Time program is available to males and females ages 12-17 and offers a physical exam, screening for sexually transmitted diseases (STDs), and a year’s supply of contraception of their choice at no cost. An office visit fee of $25 is charged for follow-up visits between the annual examinations.

While PPSPBBC has offered the Teen Time program at its Boca Raton site one afternoon a week for the past five years, it realized that it was not reaching all the teens in need, says Shulman. A check of 1999 and 2000 Pap smears revealed that 25% of teens 14-18 already had come in contact with HPV (human papillomavirus, a major cause of cervical cancer); this finding let officials know that the trend is for people to develop physical intimacy at a younger age, says Shulman. Reviewing its patient demographics, PPSPBBC saw that many teen patients were coming from north Broward County; it is now aiming the new program at these teens.

The agency is providing the free pills through a grant from the Phoenix-based Contraception Foundation that allows them to dispense the low-dose contraceptive, Alesse (Wyeth Pharmaceuticals, Philadelphia). Alesse represents a good pill choice for young women for contraception, menstrual suppression, or treatment of pelvic pain, Shulman states. While the grant ends after December 2004, PPSPBBC intends to continue with the Teen Health Broward program, she says.

Patients using the Teen Health Broward program are not scheduled in any specific block of time, unlike the Teen Time program, explains Shulman. Some teens don’t want to run into their peers, which can happen during a dedicated service time, she explains.

"They come in as part of the regular patient schedule," she states. "They are not isolated; they are treated with the respect and dignity of a private health facility."

Get the word out

Marketing of the program has been conducted mostly through word of mouth, says Shulman. The agency posted a notice on www.teenwire.org, the New York City-based Planned Parenthood Federation of America’s national teen web site, and issued a press release, which appeared in a local newspaper. Since that time, a local television station has aired a report on the program, she states.

What do teens want to know when they come to the clinic? Confidentiality is one concern, says Liz Santarsiero, NP, clinician manager of the Fort Lauderdale site. While clinicians encourage parental involvement, they talk with teens about their desire for private care. Many teens are opting to bring a parent or family member with them, she notes.

Many teens are curious about the birth control pill and how it affects their body. Clinicians give a thorough description of the Pill’s mode of action and emphasize that it does not provide STD prevention, she states.

"I spend a lot of time just talking before the exam to explain exactly what the exam is like, because a lot of teens have never been to a gynecologist or any health care professional other than maybe a pediatrician," says Santarsiero. "It is really important for us to stress here how it is a nonjudgmental environment, that they can come to us in confidence."

Education is an important piece of the examination, she notes. Even though many teens are coming for birth control, clinicians discuss that abstinence is an option.

"Even if you have had sex before doesn’t mean you have to keep having it," she explains. "We try to cover all aspects of care."

Source

For more information on the Teen Health Broward program, contact: