Addressing Unintended Teen Pregnancy Through Reproductive Health Service Delivery by School Nurses and Physicians

BACKGROUND: The Connecting Adolescents to Comprehensive Healthcare (CATCH) program built upon existing infrastructure for school nurses and physicians to provide limited reproductive health services to New York City public high school students. We evaluated CATCH reach, service delivery, and impacts on contraceptive use and pregnancy among female teens over the period 2011-2019. METHODS: Our evaluation incorporated data from school rosters and CATCH patient records; the NYC Youth Risk Behavior Survey, to estimate contraceptive use among students without CATCH access for comparison with students with access; and NYC vital statistics, to estimate the pregnancies, abortions, and births averted by CATCH. RESULTS: CATCH grew from piloting on five campuses to operating on 61 campuses with more than 80,000 students, reaching an estimated 53.7% of sexually active female students on those campuses by the 2018-19 school year. Use of most or moderately effective contraception (IUD, implant, pills, patch, ring, or Depo-Provera) among CATCH patients increased over time and was consistently higher than estimates for those same students if they had not had CATCH access. We estimate the program averted 3526 pregnancies among NYC teens. CONCLUSIONS: By supporting access to reproductive health care, CATCH contributed to contraceptive uptake and reduced pregnancies among NYC teens.