Abstract
Study Objective
We applied a patient-centered care (PCC) framework to explore incarcerated girls’
experiences of and preferences for family planning (FP) care.
Design
We conducted qualitative semistructured interviews with incarcerated girls to explore
domains of PCC: access to care, patient preferences, information and education, emotional
support, family and friends, physical comfort, coordination of care, and continuity
and transition.
Setting
A juvenile detention center (JDC) in an urban California county.
Participants
Girls incarcerated during the study period.
Interventions and Main Outcome Measures
Transcripts were analyzed using directed content analysis to identify themes related
to PCC and additional overarching themes.
Results
Twenty-two participants completed interviews. Overarching themes of stigma and autonomy
emerged as influential in girls' experiences and preferences for FP care. Participants
described stigma related to incarceration, sexual activity, and lack of contraception
use. Participants' desire for autonomy contributed to concerns around FP care. Despite
this, most desired access to FP care while incarcerated. Many valued relationships
they had with JDC providers, reporting more trust and familiarity with JDC providers
than those in the community. Constraints of incarceration decreased availability of
emotional supports and decreased involvement of family in health-related decision-making,
which worsened girls’ experiences with FP care and enhanced their sense of autonomy.
Difficulties with care coordination and transitions between the JDC and community
often resulted in fragmented care.
Conclusion
Providing patient-centered FP care in JDCs is desirable but complex, and requires
prioritizing patient preferences while recognizing the strengths and limitations of
providing FP care within JDCs.
Key Words
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Article info
Publication history
Published online: June 07, 2019
Footnotes
The authors indicate no conflicts of interest.
Initial findings were presented, in part, at the Fellowship in Family Planning Annual Meeting on May 6, 2017, in San Diego, California.
Identification
Copyright
© 2019 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
