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Title: Drop-in clinics for teenagers in Primary Care : a study to determine their acceptability, effectiveness and cost
Author: Ayres, Richard
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2005
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Objectives: 1) To investigate teenagers views on and use of sexual health services, and to explore barriers to accessing contraception. 2)To see whether the introduction of dedicated nurse-run general practice-based teenage drop-in clinics for sexual health would increase the uptake of contraceptive services by young people as compared to traditional GP services Design: Qualitative data was collected via Focus Group Discussions and questionnaires. Attendance data for teenagers was obtained from the Health Authority and Family Planning service. Effectiveness and cost were investigated by means of a cluster randomised controlled trial in general practice. Setting: Rural and urban communities in the North and East Devon Health Authority area of South West England. Outcome measures: Qualitative data was analysed thematically (perceptions of service providers, sources of advice and guidance, barriers to service use). Quantative data was used to build up a picture of teenage sexual activity and sevice use. The controlled trial used the proportion of registered teenagers obtaining contraception as its outcome, with an aim to increase this by 10%. Results: The qualitative data confirmed that many sexually active teenagers are not regularly using contraception in the project area and that serious barriers exist that impede access to contraceptive services. These are explored. The controlled trail results showed that the proportion of teenagers obtaining contraceptive services was higher overall in case as compared to control practices (an increase of 2.03% against a decrease of 2.22% in control practices), however the target of a 10% increase in contraceptive provision was not met. Case practices showed very great variation in the numbers attending the drop-ins. Those attending the clinics were younger (25% under 16 years) than those using normal GP services and 42% had not previously attended any service. Conclusions: Most teenagers obtain contraceptive services from general practice (especially in rural areas) but issues such as transport, confidentiality and anonymity should be addressed to improve access. This is crucial if government targets to reduce the high rates of teenage pregnancy in the UK are to be achieved. A weekly, hour long nurse-run drop-in sexual health service for teenagers in general practice produced a small increase in the proportion of teenagers obtaining contraception and was popular among teenagers and staff. Longer opening times and other locations might further improve effectiveness.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available