P2.A010: Closing the Knowledge Gap: Enhancing Contraception Education for Adolescents at El Rio Community Health Center

Purpose/Objectives: El Rio Community Health Center is located in Pima County, Arizona, where the teen birth rate exceeds the national average (19.9 births in Pima County vs 15.4 births per 1,000 females aged 15-19 in 2020). Unintended pregnancies predominantly occur in individuals who don’t use or use contraception incorrectly/inconsistently. Studies have shown that mandatory sexual/reproductive health education in schools lowers teen pregnancy rates, yet it’s optional in Arizona. El Rio’s teen clinic is uniquely positioned to compensate for inadequate education in schools using peer-to-peer and clinician-to-patient interactions. We strived to identify patients’ gaps in knowledge to improve education at the clinic.

Design/Methods: Patients at the clinic who met criteria (having a uterus, aged 15-21) had the option to complete a survey about reproductive health topics before their visit. A peer educator then gave a presentation on those topics, followed by clinician counseling based on the patient’s contraception preference. The survey was repeated after the visit. Items 1-8 were multiple choice questions. Items 9-10 asked participants to rate their confidence from 1 (least confident) to 5 regarding knowledge of their contraceptive choice and comfort in discussing options at the clinic, respectively.

Results: 55 participants were surveyed. Items 1-3, 5, 7-8 were scored on accuracy (Figure 1). Participants performed best on 2, 5, 7-8 (pregnancy misconceptions, acquiring emergency contraception, STI prevention, and STI testing, respectively) and worst on 1 and 3 (fertility timing and timeframe for using emergency contraception, respectively). A paired t-test did not show statistically significant improvement after counseling, but there was improvement based on frequencies for 3, 5, 7-8. Item 6 asked participants about additional sources for information and allowed selection of multiple answer choices (Figure 2). Google and a “trusted adult” were most commonly chosen. A paired t-test showed statistically significant increased confidence for items 9 (3.5 to 4.3, p< 0.05) and 10 (4.4 to 4.7, p< 0.05).

Conclusion/Discussion: Improved accuracy implies effectiveness of the clinic’s education, and our counseling presentation will be adjusted regarding lowest performing items. Understanding adolescents’ reliance on virtual resources and trusted adults means clinicians can dependably recommend reputable websites, and increased confidence post-visit is a testament to the clinic as a safe space for adolescents. Future iterations of the project may collect demographic information to elucidate potential trends in reproductive health knowledge. Effective sexual education in the clinic is helpful when adolescents rely more heavily on healthcare providers for information. It cannot be said whether these clinic-specific educational efforts will significantly decrease the teen birth rate, but in conjunction with school curriculum, we remain hopeful about the positive impact accurate and thorough sexual education can have on adolescents’ health. Lastly, we are extremely grateful for our peer educators. Crucial clinic services would not be possible without them.