Enhancing Youth Access to Reproductive Health Services in Rural Communities Through Clinical and Educational Interventions in Upstate New York, USA.

Abstract

Introduction: Access to sexual and reproductive health care has been a critical issue affecting public health outcomes, particularly for the youth population. This project identified common barriers to accessing sexual and reproductive health care for youth in rural areas and applied multiple educational and clinical interventions that helped enhance access to care.

Methodology: We designed a three-year-long program at Finger Lakes Community Health (FLCH) in rural upstate New York that involved youth, their parents or caregivers, educators, and medical professionals to improve youth access to care. Using results from a survey with 1155 youth participants to determine the barriers to care, we designed the program to overcome the fear of seeking help, basic facts ignorance, transportation issues, parental opposition, and financial issues. We implemented multiple interventions, including providing adequate education and school services, ensuring privacy and confidentiality, changing work hours, establishing phone and online services, facilitating transportation, and reducing cost barriers.

Results: The results were dramatic. Sexual and reproductive health visits to FLCH from youth in the region increased significantly from 280 in 2017 to 1100 in 2019. Even during the COVID-19 pandemic, when the number of visits slightly decreased, visits were still better than before 2018. In 2023, the number of reproductive health visits was 990, which is 3.5 times the visits in 2017.

Discussion: This study emphasizes the substantial role that tailored interventions can play in enhancing reproductive health access for youth in rural areas, significantly promoting healthcare equity and service utilization. These interventions reduce healthcare use inequities and foster potential improved public health outcomes. While our study did not directly measure clinical outcomes, the substantial increase in utilization represents an important step toward achieving them and underscores the need for further research to evaluate resulting health outcomes.