Availability of services for emergency contraceptive pills at high school-based health centers

School-based health centers have the potential to increase adolescents' awareness of, access to and use of emergency contraceptive pills, which can prevent unintended pregnancy following unprotected sex.

In 2001, 250 high school-based health centers responded to a nationwide mail survey that assessed the provision of education, referral and prescription services for emergency contraceptive pills, as well as the perceived benefits and barriers related to offering these services. Frequencies, cross-tabulations and logistic regression models were used to analyze the data.

Fifty-nine percent of the centers provided education and referrals for emergency contraceptive pills, while 30% provided prescriptions. Staff generally identified the same benefits of and barriers to services, although centers that provided services were more likely than nonproviders to report benefits and less likely to report barriers. Predictors of offering education were providing reproductive health services (odds ratio, 4.6) and citing the increased likelihood that students would use the method (3.5) and have the opportunity to discuss contraception (2.6). Reporting the benefit of pregnancy prevention was a predictor of offering referrals (2.9), while providing reproductive health services (30.4) and citing pregnancy prevention (6.3) were predictors of offering prescriptions. Predictors of the decreased likelihood of offering services were also identified.

School centers that provide all three services have the greatest potential to ensure the successful use of emergency contraceptive pills by adolescents. While the number of centers offering services appears to be increasing, greater efforts are needed to improve students' awareness of and access to the method so they can make informed decisions regarding their reproductive health.