TABLE 2

Barriers to Reproductive Care Provision (N = 68)

Barriern (%)a
AgreebNeutralDisagreec
Patient level
 Adolescents give inaccurate responses about sexual risk behaviors33 (49)13 (19)19 (28)
 Adolescents fear that parents will be notified about sexual health behaviors31 (46)14 (21)20 (29)
 Parents will be upset if pregnancy prevention is discussed with their adolescentsd9 (13)14 (21)44 (65)
 Parents will be upset if requested to allow private discussion with their adolescentsd9 (13)14 (21)44 (65)
Provider level
 Lack of follow-up of adolescent patients who are prescribed emergency contraceptiond43 (63)9 (13)15 (22)
 Insufficient knowledge about contraception40 (59)9 (13)16 (24)
 Lack of sufficient time to personally provide care36 (53)12 (18)17 (25)
 Insufficient knowledge about reproductive health referral resources30 (44)8 (12)27 (40)
 Insufficient knowledge regarding pregnancy risk among adolescents identifying as lesbian, gay, bisexual, transgender, or questioning their sexual orientation28 (41)12 (18)25 (37)
 Lack of clinician interest in adolescent health issues23 (34)14 (21)28 (41)
 Side effects of hormonal contraceptiond21 (31)18 (26)28 (41)
 Religious beliefs of clinician18 (26)6 (9)41 (60)
 Clinician discomfort in obtaining a confidential sexual history17 (25)10 (15)38 (56)
 Insufficient knowledge of how to discuss sexual risk reduction15 (22)9 (13)41 (60)
 Insufficient knowledge of how to discuss pregnancy prevention11 (16)10 (15)44 (65)
 Liability regarding prescribing contraception to adolescentsd8 (12)17 (25)42 (62)
System level
 Lack of ancillary staff experience32 (47)12 (18)21 (31)
 Lack of adequate reimbursement for time spent counseling adolescents on pregnancy prevention8 (12)13 (19)44 (65)
 Resistance from ancillary staff to provide reproductive health services8 (12)19 (28)38 (56)
 Resistance from administration to provide reproductive health services7 (10)19 (28)39 (57)
Multilevele
 Cultural differences between clinicians and patients30 (44)12 (18)23 (34)
 Sex differences between clinicians and patients18 (26)14 (21)33 (49)
  • Missing data were included in calculations.

  • a Unless otherwise noted, missing data: n = 3.

  • b Those who reported agreement with the barrier statement: agree = “agree” or “strongly agree.”

  • c Those who reported disagreement with the barrier statement: disagree = “disagree” or “strongly disagree.”

  • d Missing data: n = 1.

  • e Barriers that cross multiple levels (eg, provider and patient levels).