School
School of Public Health
Document Type
Dissertation
Department (new version)
Public Health
Date of Award
1998
Degree Name by School
Doctor of Public Health (DrPH) School of Public Health
Abstract
Objectives. The purpose of this study was to determine: (1) whether characteristics of Alabama's Title X family planning clinics influenced birth, abortion, and pregnancy rates of adult women, teenagers and all women; and (2) if there was an effect, whether it was through the intervening variables of client contraceptive behavior. Methods. Measures for clinic access and quality were obtained primarily from administrative reports and billing records routinely collected by the Alabama Department of Public Health for 1993-1995, using 65 of Alabama's counties as the units of analysis. Outcomes were county birth, abortion, and pregnancy rates for 1994-1996. Linear regression was used to determine the associations of clinic characteristics and outcomes, controlling for county sociodemographic characteristics and county services. Results. Counties with higher staffing levels and with master's level nurse practitioners had lower birth and pregnancy rates among adult and all women. Longer waits to obtain appointments were associated with higher birth rates for adult women. Counties that received more funding had lower pregnancy rates. Less funding and more provider hours were associated with higher abortion rates for all age groups. Measures of quality had the strongest effect on teen birth, abortion, and pregnancy rates, with higher error rates in consent documentation associated with lower birth and pregnancy rates, and higher error rates in initial patient education associated with higher abortion rates. Conclusions. These findings suggest that Alabama's Title X program would be more likely to achieve its goal of reducing unintended pregnancy if it increased the education of the nurse practitioners who serve family planning patients and raised its staffing levels. A portion of funding allocations should be based on program participation, but funding should also support special projects such as needs assessments to identify and reduce the barriers in some counties. Improving the quality, quantity and format of the data collected by the Title X program would make it more useful to health department staff and policy makers, as well as encouraging research on program effectiveness.
ProQuest Publication Number
ProQuest ID
9910776
ISBN
978-0-599-08875-7
Recommended Citation
Snively, Margaret Beatrice, "Family planning clinic characteristics and their influence on contraceptive behavior and pregnancy rates in Alabama, 1994-1996" (1998). All ETDs from UAB. 7200.
https://digitalcommons.library.uab.edu/etd-collection/7200
Comments
DrPH