Parental attitudes on contraception provision at school-based health clinics in the Greater New Orleans region
Awarded 2019
Complex Family Planning Fellowship Research
Elise Boos, MD
Albert Einstein College of Medicine

Louisiana has a geographically wide reaching and robust network of school-based health centers (SBHC) that were established “to provide convenient access to comprehensive, primary and preventive physical and mental health services” for adolescents. Louisiana also had the sixth highest rate of teen pregnancy in 2016, as well as some of the highest infection rates in the nation for gonorrhea, chlamydia, syphilis, HIV, and congenital syphilis. While an increasing number of SBHCs across the United States are able to offer contraception to students, so as to address adolescent reproductive preventative health needs, in Louisiana SBHCs are restricted by the mandates of the Adolescent School Health Initiate Act, which prohibits distribution of any contraceptive methods.
Adolescent reproductive health is a burgeoning and contentious issue in Louisiana where recent legislative attempts to mandate state-wide comprehensive sexual education were thwarted by opponents who claimed parents did not want comprehensive sexual education taught in the schools.  In response, the Louisiana Public Health Institute released a parental survey in 2017 which showed a majority of Louisiana parents supported comprehensive sex-education. The survey also found an overwhelming majority of parents believed schools should educate children on how to use and where to get birth control and condoms. Appreciating the important role that parents play as adolescent reproductive health stakeholders, we propose to investigate parental perceptions of contraception and reproductive health provision within school-based health centers in Louisiana, with a focus on female methods of contraception.
The primary objective of this study is to understand why parents and caregivers of Louisiana adolescents believe that contraception should or should not be provided and made available to youths in the SBHCs in Louisiana.  The secondary aim is to gain an understanding of the ways in which parents and caregivers currently perceive, navigate, and access reproductive health services for their teenage dependents in Louisiana, with a focus on access to female methods of contraception. 
This qualitative study will be conducted utilizing in-depth phone interviews that apply a semi-structured interview guide. Interviews will take place with English speaking parents and caregiversof female adolescents who are between the ages of 13 and 19 years, as well as with parents and caregivers who have parented a female adolescent in Louisiana within the past 5 years. All participants will reside within Louisiana and will be recruited to participate through social media parent groups, preexisting parental advisory committees, local organizations and events, and snowball sampling. All participants will complete a baseline demographic and geographic survey prior to the interview. Interviews will continue until thematic saturation is reached with a current plan for 20-40 interviews. Interviews will be recorded and transcribed. Transcriptions will be coded by two independent coders and themes will be analyzed using a grounded theory approach. For their time, participants will be appropriately compensated. 
Anticipated Outcomes:
Parental perspectives, values and knowledge can dramatically impact adolescent reproductive health as well as the political motivation to expand services to such. Our findings regarding parents’ permissive or intolerant perspectives will be used to meaningfully build upon state and local efforts to expand accessible, confidential and convenient reproductive health services to adolescents in Louisiana.