Youth-Friendly Family Planning Services for Young People

A Systematic Review


      “Youth-friendly” family planning services, services tailored to meet the particular sexual and reproductive health needs of young people (aged 10–24 years), may improve reproductive health outcomes, including reduction of unintended pregnancy. The objectives of this systematic review were to summarize the evidence of the effect of youth-friendly family planning services on reproductive health outcomes and to describe key characteristics of youth-friendly family planning interventions. The review, conducted in 2011, was used to inform national recommendations on quality family planning services.

      Evidence acquisition

      Several electronic bibliographic databases, including PubMed, PsycINFO, and Popline, were used to identify relevant articles published from January 1985 through February 2011.

      Evidence synthesis

      Nineteen articles met the inclusion criteria. Of these, six evaluated outcomes relevant to unintended pregnancy, contraceptive use, and knowledge or patient satisfaction. The 13 remaining studies identified perspectives on youth-friendly characteristics. Of the studies examining outcomes, most had a positive effect (two of three for unintended pregnancy, three of three for contraceptive use, and three of three for knowledge and/or patient satisfaction). Remaining studies described nine key characteristics of youth-friendly family planning services.


      This review demonstrates that there is limited evidence that youth-friendly services may improve reproductive health outcomes for young people and identifies service characteristics that might increase their receptivity to using these services. Although more rigorous studies are needed, the interventions and characteristics identified in this review should be considered in the development and evaluation of youth-friendly family planning interventions in clinical settings.
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        • Martin J.
        • Hamilton B.
        • Osterman M.
        • Curtin S.
        • Mathews T.
        Births: final data for 2013.
        Natl Vital Stat Rep. 2015; 64
        • Brindis C.D.
        • Morreale M.C.
        • English A.
        The unique health care needs of adolescents.
        Future Child. 2003; 13: 117-135
        • Tylee A.
        • Haller D.M.
        • Graham T.
        • Churchill R.
        • Sanci L.A.
        Youth-friendly primary-care services: how are we doing and what more needs to be done?.
        Lancet. 2007; 369: 1565-1573
        • Morreale M.C.
        • Kapphahn C.J.
        • Elster A.B.
        • Juszczak L.
        Access to health care for adolescents and young adults. Position paper of the Society for Adolescent Medicine.
        J Adolesc Health. 2004; 35: 342-344
        • WHO
        Adolescent-Friendly Health Services: An Agenda for Change.
        WHO, Geneva2002
        • Mulye T.P.
        • Park M.J.
        • Nelson C.D.
        • Adams S.H.
        • Irwin Jr, C.E.
        • Brindis C.D.
        Trends in adolescent and young adult health in the United States.
        J Adolesc Health. 2009; 45: 8-24
        • Oberg C.
        • Hogan M.
        • Bertrand J.
        • Juve C.
        Health care access, sexually transmitted diseases, and adolescents: identifying barriers and creating solutions.
        Curr Probl Pediatr Adolesc Health Care. 2002; 32: 320-339
      1. U.S. Congress Office of Technology Assessment. Adolescent Health—Volume I: Summary and Policy Options. 1991.

      2. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.
        in: Hagan J. Shaw J.S. Duncan P.M. 3rd ed. American Academy of Pediatrics, Elk Grove Village, IL2008
        • Sawyer S.M.
        • Afifi R.A.
        • Bearinger L.H.
        • et al.
        Adolescence: a foundation for future health.
        Lancet. 2012; 379: 1630-1640
        • WHO
        The Second Decade.
        WHO, Geneva2001
        • Newacheck P.W.
        • Brindis C.D.
        • Cart C.U.
        • Marchi K.
        • Irwin C.E.
        Adolescent health insurance coverage: recent changes and access to care.
        Pediatrics. 1999; 104: 195-202
        • Lerand S.J.
        • Ireland M.
        • Boutelle K.
        Communication with our teens: associations between confidential service and parent-teen communication.
        J Pediatr Adolesc Gynecol. 2007; 20: 173-178
        • Kavanaugh M.L.
        • Jerman J.
        • Ethier K.
        • Moskosky S.
        Meeting the contraceptive needs of teens and young adults: youth-friendly and long-acting reversible contraceptive services in U.S. family planning facilities.
        J Adolesc Health. 2013; 52: 284-292
        • Cheng T.L.
        • Savageau J.A.
        • Sattler A.L.
        • DeWitt T.G.
        Confidentiality in health care. A survey of knowledge, perceptions, and attitudes among high school students.
        JAMA. 1993; 269: 1404-1407
        • Reddy D.M.
        • Fleming R.
        • Swain C.
        Effect of parental notification on adolescent girls׳ use of sexual health care services.
        JAMA. 2002; 288: 710-714
        • Ambresin A.E.
        • Bennett K.
        • Patton G.C.
        • Sanci L.A.
        • Sawyer S.M.
        Assessment of youth-friendly health care: a systematic review of indicators drawn from young people׳s perspectives.
        J Adolesc Health. 2013; 52: 670-681
        • Gavin L.E.
        • Moskosky S.B.
        • Barfield W.D.
        Introduction to the supplement: development of federal recommendations for family planning services.
        Am J Prev Med. 2015; 49: S1-S5
        • Gavin L.
        • Moskosky S.
        • Carter M.
        • et al.
        Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs.
        MMWR Recomm Rep. 2014; 63: 1-54
        • Tregear S.J.
        • Gavin L.E.
        • Williams J.R.
        Systematic review evidence methodology: providing quality family planning services.
        Am J Prev Med. 2015; 49: S23-S30
        • Division of Reproductive Health, National Center for Chronic Disease Prevention Health Promotion, CDC
        U.S. selected practice recommendations for contraceptive use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition.
        MMWR Recomm Rep. 2013; 62: 1-60
        • Brittain A.W.
        • Williams J.R.
        • Zapata L.B.
        • et al.
        Confidentiality in family planning services for young people: a systematic review.
        Am J Prev Med. 2015; 49: S85-S92
      3. U.S. Preventive Services Task Force. Procedure manual. 2008;

        • Guyatt G.H.
        • Oxman A.D.
        • Kunz R.
        • et al.
        Going from evidence to recommendations.
        BMJ. 2008; 336: 1049-1051
        • Briss P.A.
        • Zaza S.
        • Pappaioanou M.
        • et al.
        Developing an evidence-based Guide to Community Preventive Services—methods. The Task Force on Community Preventive Services.
        Am J Prev Med. 2000; 18: 35-43
        • Brindis C.D.
        • Geierstanger S.P.
        • Wilcox N.
        • McCarter V.
        • Hubbard A.
        Evaluation of a peer provider reproductive health service model for adolescents.
        Perspect Sex Reprod Health. 2005; 37: 85-91
        • Gupta S.
        • Hogan R.
        • Kirkman R.J.
        Experience of the first pelvic examination.
        Eur J Contracept Reprod Health Care. 2001; 6: 34-38
        • Herz E.J.
        • Olson L.M.
        • Reis J.S.
        Family planning for teens: strategies for improving outreach and service delivery in public health settings.
        Public Health Rep. 1988; 103: 422-430
        • Morrison A.
        • Mackie C.M.
        • Elliott L.
        • Elliott L.M.
        • Gruer L.
        • Bigrigg A.
        The Sexual Health Help Centre: a service for young people.
        J Public Health Med. 1997; 19: 457-463
        • Wilson S.
        • Daniel S.
        • Pearson J.
        • Hopton C.
        • Madeley R.
        An evaluation of a new teenage clinic and its impact on teenage conceptions in Nottingham from 1986 to 1992.
        Contraception. 1994; 50: 77-86
        • Winter L.
        • Breckenmaker L.C.
        Tailoring family planning services to the special needs of adolescents.
        Fam Plann Perspect. 1991; 23: 24-30
        • Alberti P.M.
        • Steinberg A.B.
        • Hadi E.K.
        • Abdullah R.B.
        • Bedell J.F.
        Barriers at the frontline: assessing and improving the teen friendliness of South Bronx medical practices.
        Public Health Rep. 2010; 125: 611-614
        • Brindis C.D.
        • Loo V.S.
        • Adler N.E.
        • Bolan G.A.
        • Wasserheit J.N.
        Service integration and teen friendliness in practice: a program assessment of sexual and reproductive health services for adolescents.
        J Adolesc Health. 2005; 37 ( 155-162
        • Chambers R.
        • Boath E.
        • Chambers S.
        Young people׳s and professionals׳ views about ways to reduce teenage pregnancy rates: to agree or not agree.
        J Fam Plann Reprod Health Care. 2002; 28: 85-90
        • Cromer B.A.
        • McCarthy M.
        Family planning services in adolescent pregnancy prevention: the views of key informants in four countries.
        Fam Plann Perspect. 1999; 31: 287-293
        • Donovan C.
        • Mellanby A.R.
        • Jacobson L.D.
        • Taylor B.
        • Tripp J.H.
        Teenagers׳ views on the general practice consultation and provision of contraception. The Adolescent Working Group.
        Br J Gen Pract. 1997; 47: 715-718
        • French R.S.
        The experience of young people with contraceptive consultations and health care workers.
        Int J Adolesc Med Health. 2002; 14: 131-138
        • Hayter M.
        Reaching marginalized young people through sexual health nursing outreach clinics: evaluating service use and the views of service users.
        Public Health Nurs. 2005; 22: 339-346
        • Ingram J.
        • Salmon D.
        “No worries!” Young people׳s experiences of nurse-led drop-in sexual health services in South West England.
        J Res Nurs. 2007; 12: 305-316
        • Kapphahn C.J.
        • Wilson K.M.
        • Klein J.D.
        Adolescent girls׳ and boys׳ preferences for provider gender and confidentiality in their health care.
        J Adolesc Health. 1999; 25: 131-142
        • Peremans L.
        • Hermann I.
        • Avonts D.
        • Van Royen P.
        • Denekens J.
        Contraceptive knowledge and expectations by adolescents: an explanation by focus groups.
        Patient Educ Couns. 2000; 40: 133-141
        • Perry C.
        • Thurston M.
        Meeting the sexual health care needs of young people: a model that works?.
        Child Care Health Dev. 2008; 34: 98-103
        • Russell S.T.
        • Lee F.C.H.
        Practitioners׳ perspectives on effective practices for Hispanic teenage pregnancy prevention.
        Perspect Sex Reprod Health. 2004; 36: 142-149
        • Wilson A.
        • Williams R.
        Sexual health services: what do teenagers want?.
        Ambulatory Child Health. 2000; 6: 253-260
        • Sigman G.
        • Silber T.J.
        • English A.
        • Epner J.E.
        Confidential health care for adolescents: position paper of the Society for Adolescent Medicine.
        J Adolesc Health. 1997; 21: 408-415
      4. Cross T, Bazron B, Dennis K, Isaacs M. Towards a culturally competent system of care, volume 1. Georgetown University Child Development Center, CASSP Technical Assistance Center 1989.

        • Slater C.
        • Robinson A.J.
        Sexual health in adolescents.
        Clin Dermatol. 2014; 32: 189-195