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PubMed1987

Family planning for inner-city adolescent males: pilot study.

The results of a pilot family planning program (FPP) in a pediatric practice are reported for 66 inner-city male adolescents. The FPP was designed to eliminate registration barriers to the procurement of contraceptives by adolescent males, and to prompt the community neighborhood health center (CNHC) providers to initiate discussion of birth control with their male adolescent patients. Utilization data show that males were more likely to receive contraceptives if the provider first raised the topic of birth control to them. Unstructured follow-up interviews with 27 adolescent male FPP users identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives from the CNHC. If health care providers are sensitive to male adolescents' feelings about birth control, community health centers potentially could serve as a cost-effective source of contraceptives for sexually active male adolescents.

Adolescent↗
PubMed1987

[Program of scientific research in the field of occupational medicine 1986-1990].

Changes in the system of research planning and co-ordination in Poland promoted the development of centrally supervised programs with preferences in financial terms. Of 100 centrally supervised programs, four are related to medical sciences, in this one--to occupational health. The research program, accepted after a profound discussion, has been mainly directed towards: progress in reliable evaluations of work environment in national economy; establishment of interrelationships between work conditions and workers' health in many industrial branches; and development and enforcement of effective preventive measures. Priority is given to the following research trends, the results of which may significantly affect the efficiency of health- and preventive care rendered to workers: development and control of new methods for early diagnosis of health lesions prior to clinical pathology and prior to the occurrence of work disablement, whether temporary or durable; development and enforcement of methods allowing to single out workers susceptible to the effects of particular environmental hazards with the aim of avoiding unforeseeable health effects of occupational exposure. determination and verification of conditions promoting the effectiveness of the primary health care for workers covered by the industrial health service. development and verification, under model conditions, of the principles of organizing and functioning of the primary health care, especially preventive care, for workers of small plants which hitherto have not been covered by the industrial health service. development of a more effective--than the hitherto functioning--system of rehabilitation for disabled people, especially occupational rehabilitation being accomplished at special workplaces. A detailed list of goals planned to be achieved up till 1990 has been attached to the complete version of the paper.

Health Services Research↗
PubMedDate not supplied

Family planning clinic services in U.S. counties, 1983.

Organized family planning clinics are a major source of contraceptive services for low-income women, who are less likely than higher income women to be using a contraceptive method. A 1983 study estimated that 9.5 million U.S. women with family incomes below 150 percent of poverty were at risk of unintended pregnancy, and identified a network of 5,106 clinics providing them with services. Seventy-six percent of all counties in the United States have organized clinics that offer family planning services; almost all of those without services are nonmetropolitan counties. An estimated 52 percent of low-income women at risk of unintended pregnancy were served by organized family planning clinics in 1983, while the rest either went unserved or sought care elsewhere. Ten percent of low-income women not served by clinics live in counties that have no family planning clinics, but 67 percent live in counties where existing clinics reach fewer than half of potential low-income patients. More sites may be needed, particularly in counties without clinics, to effectively serve low-income women at risk of unintended pregnancy. However, since the majority of unserved women live in counties where at least one clinic exists, coverage might be improved through increased accessibility and outreach.

Community Health Centers↗
PubMedDate not supplied

Sterilization approval and follow-through in Brazil.

The purpose of this study was to examine the factors that affect approval for and completion of sterilization in Rio de Janeiro. Of 2,186 new female family planning clients, 1,256 requested sterilization and 925 were approved for surgery. Among the approved women, 639 scheduled surgery and, of these, 595 were sterilized within three months of approval. While approval is dependent mainly on demographic variables, especially age and parity, follow-through by a woman is related to her education and income. The steps that a woman must complete to obtain a sterilization also affect whether she ultimately undergoes surgery. Almost no women were scheduled for sterilization during their initial clinic visit. Women who were not scheduled because they lacked certain documentation were more likely to follow through than women who, in addition to lacking documentation, were asked to switch from an inefficient contraceptive method (or no method) to a more modern one. The lessons to be learned from this study provide useful information to programs in other countries that are concerned about maintaining high standards but do not want to discourage women in their efforts to be sterilized.

Adult↗
PubMedDate not supplied

Abortion attitudes and performance among male and female obstetrician-gynecologists.

Recently trained female obstetrician-gynecologists in active practice have more favorable attitudes toward abortion than do recently trained male ob-gyns, and the former also are more likely to provide abortions. However, since female providers perform fewer abortions than do male providers, women's contribution to the overall volume of abortions performed is no higher than expected. In a multivariate analysis, abortion attitudes proved to be the strongest predictor of whether or not a physician provides abortions, but practice-related variables are stronger predictors of the number of abortions performed. Factors related to policy issues, such as state funding of abortions for poor women and hospital policies with respect to abortion provision, had statistically significant effects on physicians' abortion performance.

Abortion, Induced↗
PubMed1986

Motivations for adolescents' first visit to a family planning clinic.

Although family planning clinics routinely gather data on referral sources and primary reasons for visits, little is known about the "precipitating events" which motivate young women to make an appointment or show up at a clinic on a given day. In this study, 150 new patients at a large urban clinic were interviewed to determine what events or advice specifically led to their decision to approach a family planning clinic for the first time. The roles of pregnancy scares, advice from significant others, and situational factors in motivating service use are presented along with a discussion of the program implications of these findings.

Adolescent↗
PubMed1986

Parental preferences regarding sex education topics for sixth graders.

The purpose of this study was to ascertain which sex education topics parents of preadolescents regarded as appropriate for their children. The sample was comprised of 146 respondents randomly selected from a class list of sixth graders in a suburban school district. A mailed, self-administered questionnaire listing 48 possible topics was used to elicit parental response. Pretesting found the questionnaire to be highly reliable (Cronbach's alpha = .95). Overall, parents strongly supported the inclusion of a broad range of sex education topics regardless of parental age, sex, marital status, income, education, or child's sex. Moreover, parents were largely in agreement with the inclusion of sensitive topics in addition to those which were more physiological or behavioral. Catholics more often than Protestants agreed with the inclusion of birth control, abortion, and sterilization even after controlling for income and education. Thus, the findings suggest that parents of sixth graders find a broad sex education program in the school appropriate. To this end, school officials and sex educators should not overlook the needs of preadolescents for sex education solely on the basis of perceived parental opposition.

Adolescent↗
PubMedDate not supplied

The need for prenatal care in the United States: evidence from the 1980 National Natality Survey.

Seventy-eight percent of U.S. mothers begin prenatal care during the first three months of pregnancy; 18 percent wait until the second three months; and five percent wait until the third trimester or receive no care at all. Patterns of prenatal care vary widely among population subgroups: Mothers younger than 18 and unmarried mothers are the least likely to obtain first-trimester care (49 percent and 56 percent, respectively), and the most likely to obtain care only in the third trimester or none at all (about 12 percent of each group). Women aged 18-19, blacks, Hispanics, poor women and women with little education also have disproportionately high levels of very late or no care (7-9 percent). Married, white, nonpoor women, in contrast, obtain the most timely prenatal care: In 1980, only two percent initiated care in the third trimester or received no care. Compared with this subgroup of women, the population as a whole has two times the risk of obtaining inadequate care. Unmarried women run the highest relative risk (five times the risk for married, white, nonpoor women), followed by teenagers, Hispanic women, women with little education, poor women and blacks (who have from three to more than four times the risk of the comparison group).

Adolescent↗
PubMedDate not supplied

Barriers to effective family planning in Nepal.

To investigate why family planning (FP) services in the Kathmandu Valley of Nepal are underused, a study was initiated under the auspices of the Nepal Family Planning/Maternal--Child Health Project. The study was intended to provide a user perspective, by examining interactions between FP clinic staff and their clientele. "Simulated" clients were sent to 16 FP clinics in Kathmandu to request information and advice. The study revealed that in the impersonal setting of a family planning clinic, clients and staff fall into traditional, hierarchical modes of interaction. In the process, the client's "modern" goal of limiting her family size is subverted by the service system that was created to support this goal. Particularly when status differences are greatest, that is, with lower-class and low caste clients, transmission of information is inhibited.

Adult↗