Original article
What Impact Has England’s Teenage Pregnancy Strategy Had on Young People’s Knowledge of and Access to Contraceptive Services?

https://doi.org/10.1016/j.jadohealth.2007.06.006Get rights and content

Abstract

Purpose

To describe young people’s knowledge and use of contraceptive services over initial stages of England’s Teenage Pregnancy Strategy, and to investigate factors associated with use of different services.

Methods

A random location sample of young people aged 13–21 years (n = 8879) was interviewed in 12 waves over 2000–2004. Individual data were analysed to investigate factors associated with knowledge and use of contraceptive services and to observe trends over time. Area-level data were analyzed to explore differences in key variables.

Results

In all, 77% of young women and 65% of young men surveyed knew a service they could use to obtain information about sex. Amongst those who had had vaginal sexual intercourse, the most common source of contraceptive supplies was general practice for young women (54%) and commercial venues for young men (54%). Young women’s use of school-based services to obtain supplies increased significantly from 15.4% in Year 1 to 24.4% in Year 4, p < .001. Young men’s use of the commercial sector declined significantly over the same time period (60.3% to 50.6%, p = .002), while their use of general practice and family planning clinics increased (from 8.9% to 12.4%, p = .008, and 21.2% to 29.1%, p = .054, respectively). Use of family planning clinics and designated young people’s clinics was associated with first vaginal intercourse before the 16th birthday and living in a deprived area.

Conclusions

Young people’s patterns of contraceptive service use have changed since implementation of the Strategy; although no increase in overall service use was observed. The contribution of school-based services needs further exploration.

Section snippets

Methods

As part of the TPSE a national tracking survey was carried out with the aim of monitoring progress towards the Strategy’s goals. A random location sample of young people aged 13–21 years was interviewed in 12 waves at 4-month intervals between October 2000 and June 2004. Young people living in the randomly selected geographical areas (enumeration districts with on average 150 households) rather than the same individuals were interviewed at each wave. Fieldwork was spread across 200 sampling

Characteristics of respondents

Interviews were achieved with 8879 young people across the 12 waves of the tracking survey. Respondent characteristics are presented in Table 1. There were no significant variations in these characteristics over the course of the evaluation.

Knowledge of contraceptive services

In all, 77% of young women and 65% of young men interviewed between 2000 and 2004 knew of a clinic or place they could visit if they wanted advice about sex (Table 2). Proportions were higher among young women and men who reported sexual intercourse (89% and

Discussion

Improving young people’s knowledge and access to services are goals that have been set to meet the Teenage Pregnancy Strategy’s aim of reducing under 18-year-old conception rates. Little change in knowledge of contraceptive availability and services was observed, with the exception that over the 4 years more young men were aware that contraception is free of charge and condoms are freely available irrespective of age. A third of young women and just under half of young men remain unaware that

Acknowledgments

We acknowledge the following groups and individuals for their support to this work: members of the Teenage Pregnancy Strategy Evaluation Advisory Group, the Evaluation team members of BMRB (Bridget Williams, Caroline Simpson and Patsy Lamb) and Rachael Parker, the Evaluation Co-ordinator. The evaluation research was supported by a grant from the Department of Health. Ethical approval for the evaluation was gained via the Joint UCL/UCLH Committees on the Ethics of Human Research. This work was

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