Teenagers Who Use

Organized Family

Planning Services:

United States, 1978

Statistics obtained from a national sample of

visits to organized family planning clinics are

presented for women under age 20 years.

Patients are described in terms of social and

demographic characteristics in relation to

pregnancy history, contraceptive use before

and after the visit, and types of medical

services received. A comparison of the

pregnancy history and contraceptive use of

teenage women with that of women age 20

years and over is also presented.

Data on Health Resources Utilization

Series 13, No. 57

DHHS Publication No. (PHS) 81-1718

U.S. Department of Health

and Human Services

Public Health Service

Office of Health Research, Statistics,

and’Technology

National Center for Health Statistics

Hyattsville, Md.

August 1981
National Center for Health Statistics

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Deputy Director

JACOB J. FELDMAN, Ph.D., Associate Director for Analysis

and Epidemwlogy

GAIL F. FISHER, Ph.D., Associzte Director for the

Cooperative Health Statistics System

GARRIE J. LOSEE, Associate Director for Data l%ocessing

and Services

ALVAN O. ZARATE, Ph.D., Assistant Director for

International Statistics

E. EARL BRYANT, Assoctite Director for Intem”ew and

Examination Statistics

ROBERT C. HUBER, Associate ~ector for Management

MONROE G. SIRKEN, Ph.D., Associate Director for Research

and Methodology

PETER L. HURLEY, Assoctite Director for Vital and Health

(.kre Statistics

ALICEHAYWOOD, Information Officer

Divisionof Health Care Statistics

W.EDWARDBACON,Ph.D., Director

JOANF. VAN NOSTIUND, Deputy Director

STEWART C. RICE, Chie~ Family Planning Statistics Branch

Library of Congress Catalog Card Number 81-11113
‘Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Scope ofthesurvey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ‘I

Source andlimitations ofdata. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .’ . . . . . . . . . . . . . . . . . . . . . . . . . 2

Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Social and demographic characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Pregnancy history . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Contraceptive utilization andsource ofmethod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Method switching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Teenagers comparedwith olderwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Appendixes

1. Technical notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 12

Il. Definitions ofterms usedinthisreport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

111. ClinicVisit Recordfor Family Planning Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ListofText Figures

1. Percent distribution of female family planning patients underage 20years andage20years and over by number ofpregnancies, according toage: United States, 1978 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

2. Percent distribution of female family planning patients under age 20 years and age 20 years and over by prior

contraceptive method, accordingto age: United States, 1978 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

3. Percent distribution of female family planning patients under age 20 years andage20 years and over by contraceptive

method adopted orcontinued, accordingto age: United States, 1978 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

4. Percent distribution of female family planning patients underage 20years and age 20years and overby number ofabortionssince 1973, accordingtoage: United States, 1978 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

List of Text Tables

A. Number of female family planning patients under age 20years and percent distribution by selected characteristics,

according torace: United States, 1978 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

B. Number of female family planning patients under age20yearsand percentdistribution by pregnancy history, according

torace: UnitedStates, 1978... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

C. Number of female family planning patients under age 20 years and percent distribution by contraceptive history,

accordingto race: United States, 1978 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

D. Number of female family planning patients under age 20 years and percent distribution by contraceptive method

adopted orcontinued and medical services provided, accordingto race: United States, 1978. . . . . . . . . . . . . . . . . . . . 5

E. Number of female family planning patients under age 20 years and percent distribution by contraceptive method

adopted orcontinued, according to prior contraceptive method: United States, 1978. . . . . . . . . . . . . . . . . . . . . . . . . 5

...

Ill
Symbols

. . . Data not available

. . . Category not applicable

Quantity zero

0.0 Quantity more than zero but less than

0.05

z Quantity more than zero but less than

500

*

Figure does not meet standards of

reliability or precision

# Figure suppressed to comply with

confidentiality requirements
Teenagers Who Use Organized

Family Planning Services

by Eugenia Eckard, Division of Health Care Statistics

Introduction

Background

According to data from the National Reporting

System for Family Planning Services conducted by

the Division of Health Care Statistics of the National

Center for Health Statistics, 33 percent of the 3.8

million women who visited organized family planning

cIinics in 1978 were teenagers. The Alan Guttmacher

Institute estimates that 4 million females ages 15-19

years in 1975 were sexwdly active.1 This means that

approximately 3 out of 10 sexually active teenagers

in the United States used organized family planning

services in 1978.

Along with an increase in teenage pregnancies in

recent years, there is growing interest in teenagers’

knowledge and utilization of contraception. Adolescent childbearing is a major concern because of the

associated negative health, social, and economic

consequences. A variety of research evidence indicates that adolescent childbearing is associa~ed with

higher risks of ill health and social disadvantage for

both mother and child. Accordingly, it becomes

increasingly important to determine whether teenagers are using services designed to prevent unwanted

pregnancies. There is a paucity of information about

adolescents’ knowledge, attitudes, and behavior with

regard to family planning methods. The limited

data available do indicate a trend toward in~rease.d

contraceptive use by teenagers,zzs as well as increased

use of sources from which medical methods of

contraception (i.e., the oral contraceptive pill, intrauterine devices, and the diaphragm) are obtained.Q YS

The data presented here reveal that teenagers are

using the services provided by organized family

planning clinics, and, for most of them, this means

being introduced to more effective methods of

contraception.

Scope of the survey

The National Reporting System for Family Pkmning Services was begun in 1972 to collect information on family planning clinic patients in the United

States, Guam, Puerto Rico, and the Virgin Islands.

The sources of organized family planning clinics

consist of hospitals, health departments, Planned

Parenthood affiliates, and other agencies, including

community action programs, neighborhood health

centers, and freestanding clinics. Family planning

visits to private physicians’ offices are excluded from

the survey. Since mid-1 977 the survey has included

only those visits made specifically for medical services

associated with family planning. Visits for replenishing contraceptive supplies, counseling, and pregnancy

or venereal disease tests are excluded.

The survey employs a two-stage sampling design.

Of a universe of 5,619 known family planning service

sites, 1,195 were randomly selected as sample sites.

This represents about 1 in 4 sites nationally. Survey

participation is required for all facilities selected for

the sample that are supported by Public Health

Service grants for family planning services; however, participation is voluntary for nonfederally

funded service sites selected for the sample. The

proportion of the sample site’s visits systematically selected for inclusion in the survey varies

according to the site’s reported annual number of

visits and its geographic location; this averages to

about 1 in 25 visits nationality.

Other data sources from the National Center for

Health Statistics provide related statistics on utilization of family planning services. For example, data

from the National Ambulatory Medical Care Survey,

which is also conducted by the Division of Health

Care Statistics, concern visits to office-based physicians’ practices that include family planning services.

The National Survey of Family Growth, conducted

by the Division of Vital Statistics in 1973 and 1976,

provides more detailed statistics on women who made

1
family planning visits to their physicians or to

organized family planning clinics in the 3 years prior

to the survey. Unlike the other two surveys, data for

the National Survey of Family Growth were collected

by means of personal interviews with a national

sample of women age 15-44 years who were ever

married or never married and who had offspring living

in the household.

Source and limitations of data

The data in this report are based on information

obtained from observation, from the medical record,

or from the patient interview. This information is

entered onto the Clinic Visit Record, or, in those

service sites that collected survey data through

participation in a computerized record system, on

locally developed forms that contain the same 14

items as on the Clinic Visit Record. The items cover

basic sociodemographic information about the

patient and other information pertaining to family

planning (see appendix III for facsimile).

Because the 1978 National Reporting System for

Family Planning Services was based on a sample, the

data differ somewhat from data that would have been

obtained had it been based on a full count survey,

using the same data collection procedures, materials,

and the like. Therefore, estimates of small magnitudes, as well as percentage estimates based on small

numbers, may lack the precision needed for some

applications (see appendix I).

It should be emphasized that this report focuses

on the number of teenagers who used organized

family planning services, while another report6 discusses the number of visits made by teenagers to

family planning service sites. Both reports use data

from the 1978 National Reporting System for Family

Planning Services.

The following is a descriptive analysis of the

teenagers under study and includes a look at important sociodemographic characteristics in addition to

the types of services the teenagers received.

%
Highlights

..

Social and demographic characteristics

Table A presents data on selected characteristics

of teenage family planning patients according to race.

Most of the patients, both black and white, were

17-19 years of age. However, over twice as many

black teenagers as white teenagers were under 16

years of age (16.3 percent and 7.9 percent, respectively). As might be expected, most of the teenagers

had not yet completed high school, and the majority

(55.7 percent) were students at the time of their

clinic visit. Most of the patients were from families

who did not receive public assistance. However, the

racial difference is striking A larger proportion of

black teenagers were from families who received

public assistance (29.8 percent) than was true for

white teenagers (7.9 percent).

A look at the four geographic regions shows that

most of the teenagers were served in the South (36.3

percent). The proportion of teenagers who visited a

family planning clinic in the West (27.8 percent) was

larger than that for the Northeast (19.9 percent) and

North Central (16.0 percent) regions. This differs

somewhat when looking at the racial groups separately. The largest proportion of white teenagers

received family planning services in the West (34.5

percent), while more than half of the black teenagers

received family planning services in the South (62.1

percent). Table A also reveals that most of the

teenagers who visited the clinics were new patients

(54.5 percent). This is also true for white teenagers,

while the reverse is evident for black teenagers.

Pregnancy history “

Table B shows the percent distribution of teenagers by number of pregnancies, live births, and fetal

deaths. More than half of the teenagers had never

been pregnant, while more than threequarters of

them had never had a live birth. More black teenagers

than white teenagers had experienced at least one

Table A. Number of female family planning patien~ under age 20

years and percent distribution by selected characteristic% according to race: United States, 1978

Race

Selecsr?d characteristics

Total 1 Whita Black

All patients . . . . . . . . . . . . . . . . . . . .

Total . . . . . . . . . . . . . . . . . . . . . . . .

Age

13years orunder . . . . . . . . . . . . . . . .

14yaars . . . . . . . . . . . . . . . . . ..m . .

15yeara . . . . . . . . . . . . . . . . . . . . . .

16years . . . . . . . . . . . . . . . . . . . . . .

17years . . . . . . . . . . . . . . . . . . . . . .

18years . . . . . . . . . . . . . . . . . . . . . .

19years . . . . . . . . . . . . . . . . . . . . . .

Education

Lessthan 7years . . . . . . . . . . . . . . . .

7-llyeers . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . .

Student status

Student . . . . . . . . . . . . . . . . . . . . . .

Nonstudent . . . . . . . . . . . . . . . . . . . .

Public assistance income

Income includes public assistance. . . . . .

Income does not include public

assistance . . . . . . . . . . . . . . . . . . . .

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . .

North Omtral . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . .

Visit status

initial . . . . . . . . . . . . . . . . . . . . . . .

Return . . . . . . . . . . . . . . . . . . . . . . .

Number in thousands

1,268 892 355

Percent distribution

100.0

1.0

2.5

6.8

14.0

21.5

27.1

27.1

1.2

60.0

30.8

8.0

55.7

44.3

14.1

65.9

19.9

16.0

36.3

27.8

54.5

45.5

100.0

●0.5

1.7

5.7

13.6

22.1

28.4

28.0

1.0

57.2

32.7

9.0

53.8

46.2

7.9

92.1

21.0

18.1

26.4

34.5

57.7

42.3

100.0

*2.2

4.7

9.4

15.1

20.3

23.7

24.7

●1.7

67.6

25.6

5.1

60.6

39.7

29.8

70.2

18.0

11.4

62.1

8.4

45.9

E4.1

1 I “eludes races other than white and bl~k.

NOTE: Numbers may not add to totals due to rounding.

3
Table B. Number of female family plenning patients under age 20 years

and percent distribution by pregnancy history, according to race:

United States, 1978

Race

Pregnancy history

Total I White Black

All patients . . . . . . . . . . . . . . . . . . . .

Total . . . . . . . . . . . . . . . . . . . . . . . .

Number of pregnancies

None . . . . . . . . . . . . . . . . . . . . . . . .

One . . . . . . . . . . . . . . . . . . . . . . . . .

Twoor more . . . . . . . . . . . . . . . . . . .

Number of live births

None . . . . . . . . . . . . . . . . . . . . . . . .

One . . . . . . . . . . . . . . . . . . . . . . . . .

Two ormore . . . . . . . . . . . . . . . . . . .

Numbar of fetal daaths

None . . . . . . . . . . . . . . . . . . . . . . . .

One . . . . . . . . . . . . . . . . . . . . . . . . .

Twoormore . . . . . . . . . . . . . . . . . . .

Ilncludes races other than white and black.

Number in thousands

1,268 892 355

Percent distribution

100.0 100.0 100.0

65.8 69.9 54.6

26.3 23.3 33.5

8.1 6.7 11.5

78.5 83.4 65.3

18.0 13.9 28.7

3.5 2.7 5.9

84.9 84.7 85.1

13.3 13.4 13.2

2.0 1.9 *0.2

NOTE: Numbers may not add to totels due to rounding.

pregnancy, and over twice as many black teenagers

than white teenagers had had at least one live birth.

Since cause of fetal mortality is not ascertained

within the scope ofthe survey ,dataon the number of

fetal deaths may reflect induced as well as spontaneous abortions. About 15 percent of the teenagers

had experienced at least one fetal death. There isno

difference in the number offetal deathsbetween the

two racial groups.

Contraceptive utilization andsource ofmethod

Table C shows the percent distribution of teenagers by the contraceptive method they were using

prior to their visit and the source from which the

method was obtained. About 40 percent of the

teenagers had never used a method regularly priorto

the visit. The proportion who had never used a

method regularly was similar for black and white

teenagers (39.4 percent and 40.0 percent, respectively). For those who had ever used a method, the

largest proportion, 48.8 percent, had used the oral

contraceptive pill. A smaller proportion of the teenagers used other methods, which include the intrauterine device (IUD), diaphragm, foam/jelly/cream,

and natural (e.g., rhythm), among others. Such a high

proportion of teenagers having used the pill indicates

that the source of the method for most of the

teenagers was either family planning clinics or private

physicians, as table C indicates.

The largest proportion of the teenagers returned

to the family planning clinic from which they had

Table C. Number of female family planning patients under age 20 years

and percent distribution by contraceptive history, according to

race: United States, 1978

Race

Contraceptive history

Total 1 White Bleck

All patients . . . . . . . . . . . . . . . . . . . .

Total . . . . . . . . . . . . . . . . . . . . . . . .

Prior contraceptive method

Pill . . . . . . . . . . . . . . . . . . . . . . . . .

IUD . . . . . . . . . . . . . . . . . . . . . . . . .

Diaphragm . . . . . . . . . . . . . . . . . . . .

Foam/jelly /craam . . . . . . . . . . . . . . . .

Natural . . . . . . . . . . . . . . . . . . . . . .

Sterilization . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . .

No regular method . . . . . . . . . . . . . . .

Source of prior method

Same service site . . . . . . . . . . . . . . . .

Other sa,rvice site . . . . . . . . . . . . . . . .

Hospital . . . . . . . . . . . . . . . . . . . . . .

Private physician........,.. . . . . .

Drugstore . . . . . . . . . . . . . . . . . . . .

Othar . . . . . . . . . . . . . . . . . . . . . . . .

Unknown . . . . . . . . . . . . . . . . . . . . .

Number in thousands

1,268 892 355

Percent distribution

100.0 100.0 100.0

48.8 47.6 51.5

2.3 1.8 3.4

1.3 1.6 *0.8

2.4 2.6 *2.O

*0.5 ‘0.8 *0.3

*0.3 *0.3 *0.3

4.3 5.3 *1.7

39.9 40.0 39.4

29.7 26.9 37.2

6.1 6.3 5.9

*1.1 ‘0.8 * 2.0

8.4 9.4 5.6

4.1 5.2 *1.4

2.8 3.0 *2.2

7.9 8.5 5.9

1 Includes races other than white and black.

NOTE: Numbers may not add to totals dua to rounding,

received their prior method (29.7 percent). About 7

percent received their prior method from another

clinic or from a hospital. The private physician was

the source of prior method for 8.4 percent of the

teenagers. The drug store was the source for an

additional 4 percent, while 2.8 percent received prior

methods from other sources. The source of prior

method for another 7.9 percent of the teenagers was

unknown. As for racial differences, more black

teenagers than white teenagers obtained their prior

method from a family planning clinic or from a

hospital, while more white teenagers than black

teenagers obtained their prior method from a private

physician.

Table D shows the percent distribution of teenagers by the contraceptive method they adopted or

continued at the visit and the types of medical

services they received. Nearly threequarters of the

teenagers chose or continued use of the pill. An

additional 8 percent chose either the IUD or the

diaphragm, which are other medical methods. There

was a small increase in the proportion of teenagers

who chose to use foam/jelly/cream after the visit,

compared with before the visit (5.0 percent compared

with 2.4 percent as shown in tables C and D). Almost

9 percent of the teenagers chose no method at the

visit. This general pattern can be seen for both races

separately.

4
It is also evident from table D that more than half

of the teenagers received the core medical services

provided in family planning clinics, that is, pap smear,

pelvic exam, breast exam, blood pressure, and blood

test. The pregnancy test was provided for about 10

Table D. Number of female family planning patients under age 20 years

and percant distribution by contraceptive method adopted or

continued and medical sewices provided, according to race:

United States, 1978

Contraceptive method adopted or Race

continued and medical servicas

rt?caived Total 1 White Black

Allpatients . . . . . . . . . . . . . . . . . . . .

Total . . . . . . . . . . . . . . . . . . . . . . . .

Contraceptive mathod adopted

or continued

Pill . . . . . . . . . . . . . . . . . . . . . . . . .

IUD . . . . . . . . . . . . . . . . . . . . . . . . .

Diaphragm . . . . . . . . . . . . . . . . . . . .

Foem/jelly/craam . . . . . . . . . . . . . . . .

Natural . . . . . . . . . . . . . . . . . . . . . .

Relying on partner . . . . . . . . . . . . . . .

Sterilization . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . .

Noregular method . . . . . . . . . . . . . . .

Medical services provided

Papsmear . . . . . . . . . . . . . . . . . . . . .

Pelvic exam . . . . . . . . . . . . . . . . . . . .

Breast exam . . . . . . . . . . . . . . . . . . .

Blood pressure . . . . . . . . . . . . . . . . . .

Pregnancy test . . . . . . . . . . . . . . . . . .

V. D.test . . . . . . . . . . . . . . . . . . . . .

Urinalysis . . . . . . . . . . . . . . . . . . . . .

Blood iest . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . .

Numk in thousands

1,268 892 355

Percent distribution

100.0

74.7

3.7

4.2

5.0

●0.2

2.8

*0.2

“0.5

8.7

62.8

72.4

64.4

89.8

10.1

57.5

62.5

57.1

48.0

100.0

74.3

3.2

4.9

4.5

*0.2

3.0

●0.2

‘0.6

9.1

63.7

72.6

64.0

89.0

10.9

57.1

64.3

57.6

47.6

100.0

75.8

5.1

●2.O

6.5

‘0.3

2.5

+0.3

●0.3

7.3

61.4

72.1

65.9

92.4

8.2

59.4

58.0

56.6

47.9

lTo~l includ~~ races ~~h~r th~n ~hit~ ~nd bl~ck.

NOTE: Numbers may notaddto totelsdue to rounding.

percent of the teenagers, while nearly 58 percent

received the venereal disease (V.D.) test.a A majority

of the patients also received a urinalysis (nearly 63

percent), and other medical services were provided

for 48.0 percent of the teenagers. There is no

significant difference in the types of medical services

provided to black and white teenagers.

Method switching

In table E the percent distribution of teenage

patients is shown by the contraceptive method they

adopted or continued at the end of the visit,

according to the method they had used prior to the

visit. Before the visit, 2 out of 5 patients used no

method regularly (see table C). During the visit,

nearly 70 percent of that group chose the pill, over 6

percent adopted the diaphragm or IUD, about 12

percent chose less effective methods, and the remaining 12 percent did not adopt a method. Table E also

shows that most of the teenagers whose prior method

was the pill did not switch to another method (83.9

percent). Ahnost 5 percent of the teenagers who

previously used the pill switched to the IUD or

diaphragm, another 5 percent adopted less effective

methods, and over 6 percent did not adopt a method

at the visit.

The general pattern is that teenagers whose

previous method was medical (i.e., pill, IUD, or

diaphragm) continued that method or chose another

medical method. Most teenagers who used less effective methods (i.e., foam/jelly/cream and others)

switched to the most effective methods during the

eIt is important to note that the fries reported here for the veneral

disease and pregnancy tests do not include teenagers who visited olirdcs

solely for these seMces because they were excluded from the survey

sample.

Tabla E. Numk of femala family planning patients under age 20 years and percent distribution by contraceptive method adopted or

continued, according td prior contraceptive method: Unitad States, 1978

Prior contraceptive method

Contraceptive method adopted or continued Foam/

Pill IUD Diaphragm jelly/ Other

No regular

cream

method

Number in thousands

Allpatients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 618 28 17 31 67 506

Percent distribution

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0

Pill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83.9 ●23.6 *28.7 56.7 66.6

IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2

69.9

59.0 *5.2 *5.8 *2.3

Diaphragm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5

2.4

*2.O 51.0 *8.5 *7.3 4.0

Foem/jelly/cream . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 *5.4 *I .6 * 17.9 *5.4

Relying onpartnar . . . . . . . . . . . . . . . . . . . . . . . . . 1.4

6.6

●2.6 *2.3 ●2.7 ‘6.0

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.3

*0.5 *0.4 *1 .4 *0.8 ●2.2

Noregularmethod . . . . . . . . . . . . . . . . . . . . . . . . .

1.0

6.3 *7.O *8.9 *7.8 9.6 11.7

NOTE: Numbers mey not add to totals dua to rounding.

5

1
visit. Thus the clinic provided a method to a

significant number of teenagers who had previously

used no method, and it provided a more effective

method to teenagers who had previously used a less

effective method.

Teenagers compared with older women

For comparative purposes, figures 1-4 show pregnancy history and contraceptive information for

teenagers and for women age 20 years and over.

Figure 1 shows that more teenage patients than older

patients had had no pregnancies (approximately 66

percent compared with 31 percent). The proportion

who had had one pregnancy was about the same for

both age groups. However, more older women than

teenagers had had two or more pregnancies (over 43

percent compared with about 8 percent). Figure 2

reveals that a higher proportion of older women than

of teenagers used some method of contraception and

that more of the former group used the more

effective methods.

Figure 3 shows that the proportion of teenagers

who adopted or continued use of the pill is significantly larger than that of women age 20 years and

over (nearly 75 percent compared with almost 58

percent). Larger proportions of the older women than

of the teenagers adopted the IUD and the diaphragm,

as well as other methods. However, there is no

significant difference in the proportions of teenagers

and older women who adopted foam/jelly/cream as a

method or who adopted no method. It appears, then,

that the pill is the method that is supplied to most

women who had never used a method regularly (most

of whom are teenagers).

Figure 4 reveals the number of abortions the

family planning patients had had since 1973. Most of

the women, regardless of age, had not had an

abortion during that period (nearly 86 percent for

teenagers and over 79 percent for older women).

However, a higher proportion of the older women

than of the teenagers had had at least one abortion

since 1973 (over 15 percent compared with nearly 12

percent). The proportion of teenagers who hacl had at

least one abortion since 1973 (almost 12 percent)

represents 34 percent of the teenagers who hail had at

least one pregnancy.

100

90

80

70

c

.-o

Z

60

a.-I_

.-%

-0 50

:

v

k

n. 40

30

20

10

0

65.8

❑LlncJerage20 years

n

Age 20 years and over

8.1

43.3 —

—.

One Two or more

Number of pregnancies

NOTE: Numbers may not add to totals due to rounding.

SOURCE: National Reporting System for Family Planning Services, 197S–National Center for Heelth Statistics.

Figure 1. Percent distribution of female family plenning patients under age 20 years and age 20 years and over by number of pregnancies, according

to age: United States, 1978
1cm

90

80

70

60

50

40

30

20

10

0

48.8

NUnder age 20 years

c1 Age 20 years and over

61.7

39.9

12.0

5.5

2.3 1.3

Pill IUD Diaphragm Foam/Jelly/Cream Other No regular

prior contraceptive m~hod

method

NOTE: Numbers may not add to totals due to rounding.

SOURCE: National Reporting System for Family Planning Services, 1978-National Center for Health Statistics.

Figure 2. Percent distribution of femala family planning patients under age 20 years and age 20 years and over by prior contraceptive method,

according to age: United States, 1978

7
100

r

❑lJnderage20 years

90

t

El

Age 20 years and over

80

70

qo

50

40

30

20

10

0

k 74.7

12.1

9.1

s-. 6.0 7.1 8.7 7.9

3.7 4.2 3.7 INN]

Pill IUD Diaphragm Foam/jelly/cream Other No regular

method

Contraceptive method adopted or continued

NOTE: Numbers maynotedd tototels due to rounding.

SOURCE: National Reporting System for Family Plenning Sewices, 197S-Netional Center for Health Statistics.

Figure3. Percent distribution of female family planning patients underage 20yeamand age20years andover bycontraceptive method adopted or

8

continued, according tea-$: United States, 1978
100

90

80

70

30

20

10

0

None One Two or more

Number of abortions since 1973

NOTE: Numbers may not add to totals due to roundinv

SOURCE: National Reporting System for Family Planning Services, 1978-National Center for Health Stetistiae.

Figure 4. Percent distribution of female family planning patients under age 20 years and age 20 years and over by number of abortions since 1973,

according to age: United States, 1978

*
References

1Contraceptive Services for Adolescents: United States, Each

State & County, 1975. New York: The Alan Guttmacher

Institute, 1978.

2Jaffee, F. S., and Dryfoos, J. G.: Fertility control services for

adolescents, access and utilization. Fare. Plann. Perspect. 8(4):

167-175, 1976.

3Zelnik, M., and Kantner, J. F.: Contraceptive patterns and

premarital pregnancy among women aged 15-19 in 1976. Fare.

Plann. Perspect. 10(3): 135-142, 1978.

4Dryfoos, J. G., and Heisler, T.: Contraceptive services for

adolescents: An overview. Fare. Plann. Perspect. lo(4):

223-233, 1978.

5National Center for Health Statistics: Use of family planning

services by currently married women 15-44 years of age,

United States, 1973 and 1976, by G. E. Hendershot. Advance

Data From Vital and Health Statistics, No. 45. DHHS Pub. No.

(PHS) 79-1250. Public Health Service. Hyattsville, Md. Feb. 7,

1979.

6National Center for Health Statistics: Family planning visits

by teenagers: National Reporting System for Family Planning

Services, United States, 1978, by J. Foster and E, Eckard.

Vital and Health Statistics. Series 13-No. 58. DHHS Pub. No.

(PHS) 81-1719. Public Health Service. Hyattsville, Md. In

preparation.

7Final Report of Data Quality Study for the National

Reporting System for Family Planning Services August, 1980,

hformatics. (Unpublished).

10
Appendixes

1. -. –-,-.-.--, .- —a _- 4Q

II.

Ill.

lecnnlcal no~es . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..s . . . . . . . .. s.. . ...” ‘=

Survey methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Data collection andprocessing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Reliability ofestimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Definitions oftermsusedinthis report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Clinic Visit Record forFamilyPlanning Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Li.stofappendix tables

1. Estimated numberoffemale family planning patients, byageand race: UnitedStates, 1978 . . . . . . . . . . . . . . . . . . . . 14

Il. Relativestandard error ofestimated numberoffemalefamily planning patiens, by age and race: United States, 1978 . . . 14

Ill. Number ofsample (i.e., unweighted) family planning patient records, byaWand race: United StaWs, 1978 . . . . . . . . . . 14

IV. Range ofrecommended design effects forproponion estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

11
Appendix L Technical notes

...

Survey methodology

The National Reporting System for Family

Planning Services covers all family planning visits to

nonmilitary service sites in the United States, Guam,

Puerto Rico, and the Virgin Islands that offer medical

family planning services. The survey specifically

excludes family planning visits to office-based private

physicians’ practices; these visits are included in the

National Ambulatory Medical Care Survey, which is

also conducted by the Division of Health Care

Statistics of the National Center for Health Statistics

(NCHS). A family planning patient is an individual

making one or more family planning visits to a family

planning service site.

family planning visits to a family planning service site.

Sampling design. –The data presented in this

report are based on a two-stage stratified sample

survey. The first-stage sampling frame was completed

during the summer of 1976. The frame consisted of a

list of family planning service sites enrolled in the

full-count survey (the mode in which the survey

operated prior to the adoption of the sampling

approach on July 1, 1977) augmented by lists of

family planning service sites compiled by the Bureau

of Community Health Services of the U.S. Department of Health and Human Services and by the Alan

Guttmacher Institute, which, at that time, was the

research and development division of the Planned

Parenthood Federation of America, Inc. Family

planning service sites that were identified on more

than one list were deleted from the frame prior to

sample selection.

Prior to selection of the sample service sites, the

sampling frame was arranged into six State groups,

which were formed by combining States with similar

numbers of family planning service sites. Within each

State group, each family planning service site was

classified into one of the following three classes

according to reported information for the facility’s

annual number of family planning visits: sites with

less than 1,000 visits, sites with 1,000-3,999 visits,

and sites with 4,000 visits or more. Within each of the

sampling strata defined by the six State groups and

the three visit-size classes, the service sites were

ordered by State, type of sponsorship (i.e., public

health department, affiliate of the Planned Parenthood Federation of America, Inc., hospitid, and

other), and county. The sample service sites were

systematically selected from these strata after a

random start, with the probabilityy of selection

ranging from certainty to 1 in 18. The 1978 U.S.

sample comprised 1,195 sites, with 85.1 percent of

the sites participating in the survey.

In the second stage, family planning visits at each

sample site were systematically selected. NCHS

assigned to each sample site a sampling rate dependent on the site’s reported visit volume and the State

in which the site was located. Overall, 14 visit

sampling rates were used to determine the proportion

of each site’s family planning visits needed for the

survey; the visit sampling rates ranged from certainty

to 1 in 30.

Although the survey is based on a sam~ple of

family planning visits, estimates for family planning

patients are derivable from survey data. Each patient

(i.e., an individual making one or more family

planning visits) can be uniquely associated with the

fnst visit she made during the calendar year.

The date of the prior family planning visit, if any,

for each individual making a sample family planning

visit is recorded in item 8 of the Clinic Visit Record

(see appendix HI). With this information, sample

family planning visits that correspond to an individual’s first family planning visit during the cadendar

year can be identified. Of 276,619 sample family

planning visits in the United States in 1978,, some

138,129 reflect data for the individual’s first family

planning visit during that year. The patient estimates

presented in this report are based on those 138,129

sample family planning visits (or, equivalently, rample

family planning patients).

12
Data collection and processing

Visit data were either abstracted from the patient’s

medical file or obtained by interviewing the patient or

by observation. The primary data collection form is

the Clinic Visit Record. which consists of the survey’s

minimum basic data set (see appendix III).

Each sample service site had the option of collecting data for the survey by participating in a computerized record system, provided NCHS criteria for

data collection were met. NCHS required that(1) the

record system’s data be based on a source document

that included the survey minimum basic data set, and

(2) the procedures and definitions used to collect such

data be consistent with those specified for the survey.

About 3 out of 4 sample service sites participating in

the 1978 survey collected data by participating in a

computerized record system. The remaining sites

collected survey data on Clinic Visit Records, which

were submitted to NCHS for processing.

The procedure for sampling visits was done in one

of two ways. Sample service sites that collected visit

data for the survey by participating in a computerized

record system usually opted to have the sample visits

selected by computer. The remaining sites selected

sample visits through their staffs’ maintenance of visit

logs used to list every patient making a family

planning visit. Individuals who answered “yes” to the

screening question (“Are you here to see a health

provider [physician, nurse, allied health personnel]

about obtaining health services related to contraception, infertility treatment, or sterilization?”) were

listed consecutively on the visit log. Those individuals

whose names appeared on the last line of each page in

the visit log were selected and data for those visits

were collected. Different versions of the family

planning visit logs corresponded to each of the 14

sampling rates employed to select sample visits; the

total number of lines used to list patients on the

family planning visit log was equal to the reciprocal

of the sampling fraction used by the site.

Data processi~g. –Data processing differed according to the mode of data submission. Visit data

received on Clinic Visit Records had to be keyed to

machine-readable form prior to computer processing.

Keying for all data items was independently verified

for 100 percent of the Clinic Visit Records. Visit data

received on a computer tape or on punched cards

from a computerized record system did not require

precomputer processing.

All visit data, regardless of the form of data

submission, were edited by NCHS for completeness

and consistency. Visit records with errors, inconsistencies, or item nonresponse were corrected, if

possible, through followup with the service site or the

computerized record system. Imputation was used for

specific data items when the overall level of nonresponse for an item was small.

Reliability of estimates

The survey statistics are derived by a complex

estimation procedure used to produce essentially

unbiased data. The procedure’s two principal components are inflation by the reciprocal of the probability of sample selection and adjustment for nonresponse.

Sampling error. –The statistics presented in this

report are based on a sample survey and therefore

differ from those that would be based on a full-count

(100-percent) survey that used the same data collection definitions and procedures. The probability

sampling design allows calculation of estimated standard errors from the sample data.

The standard error is primarily a measure of the

variability that occurs by chance because a sample

rather than the entire sampling frame is surveyed.

While the standard ,errors calculated for this report

reflect some of the random variation inherent in the

measurement process, they do not measure any

systematic error, or bias, that is present in the data.

One is referred to the section titled “Nonsampling

error” for additional information on measurement

error.

The chances are about 0.68 that the interval

specified by the estimate plus or minus one standard

error contains the figure that would be obtained

through a fi.dl-count survey of the sampling frame.

The chances are about 0.95 that the interval specified

by the estimate plus or minus two standard errors

contains the figure that would be obtained through a

full-count survey of the sampling frame.

In order to derive standard errors at moderate

cost that would be applicable to a wide variety of

statistics, several approximations were required. It is

necessary to utilize the estimates of domain sizes,

relative standard errors, and sample sizes shown in

tables I-III.

The standard error of proportion estimates may

be approximated by use of the design effect

approach. For data from the National Reporting

System for Family Planning Services, the design

effect varies with the size of the base of the

proportion (see table IV). With the selection of larger

values in the range of recommended design effects,

fewer comparisons of survey parameters will result in

significant differences. The largest value in each range

of recommended design effects was used to determine

reliability for this report.

Accordingly, the standard error of an estimated

proportion of patients is approximated by the following formula:

Standard error (p) = (D.E.)

J

P(i-p)

n

13
Tabla 1. Estimated number of famale family planning patients, by age and race: United States, 1978

Race

Age

Total Under 20-24 years 25-29 Vears 30 years

20 yaars and over

Number of patients in thousands

Allracesl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,815 1,268 1,402 669 475

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,616 892 987 441 296

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,118 355 386 210 167

I Include$ races ~thar than white and black.

Table 11. Relative standard error of estimated number of female family planning patients, by age and race: United States, 1978

Age

Race Total

Under 20-24 years 25-29 years

30:Vears

20 yaars and over

Relative standard error in Wrcent

Allracesl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 4.3 4.4 4.5 3.9

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 4.8 4.7 4.7 3.8

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 4.9 4.8 6.6 6.9

1Includes racaeother than whita and black.

Table I Il. Number of sample (i.e., unweighed) family planning patient records, by age and race: United States, 1978

Age

Race Total

LJndar 20-24 years 25-29years 30years

20 years anaf over

Allracesl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138,129 48,122 50,922 23,611 15,474

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99,501 35,463 37,291 16,476 10,271

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33,872 11,312 11,638 6,155 4,567

I Includes racasother than white and black.

where

p= the estimated proportion.

n = the number of sample (i.e., unweighed)

patients in the base of theproportion (see

table III).

D.E. = the design effect comesponding tothe size

of the estimated base oftheproportionp

(see table IV).

For example, 74.7 percent (p= O.747) of the

l,268,000teenage family planningpatients continued

or adopted use of the oral contraceptive pill. Thefollowing computation may be used to determine the

standard error forthisestkmted proportion:

Standarderror=7

J

(0.747) (1 - 0.747)= (I 014

48,122 .

where

p = 0.747

D.E. = 7

n=48,122

14
Table IV. Range of recommended design effects for proportion

estimates

Estimated number of

Design effect

patiants in base

Range of used in this

of proportion

recommended report to

(domain siza)

design effects determine

reliability

Lassthan l million . . . . . . . . . . . 1-5 5

l-3 million . . . . . . . . . . . . . . . . 1-7 7

Morethan3 million . . . . . . . . . . 1-7 7

and

0.014

relative stamdard =~=o.o19.

One may also wish to compute the standard error

associated with national aggregate estimates. To calculate the approximate standard error of an aggregate

estimate X, fiist compute the relative standard erro~

(RSE) of the proportion (X/Y), where Y is the aggregate estimate for the smallest category of patients

listed in tabIe I containing X population (e.g., if X is

the estimated number of teenage family pkmning patients adopting or continuing use of the oral contraceptive pill, Y is the estimated number of teenage

family planning patients).

Then

RSE(X) = ~ (RSE(X/Y))2 + (RSE(Y))2

and

standard error (X) = X RSE (X).

To continue with the example, one may calculate the

standard error of the estimated 946,000 teenage

family planning patients who continued or adopted

use of the oral contraceptive pilL

First, the approximate relative standard error of

the proportion estimate (the estimated proportion of

teenage family planning patients who continued or

adopted use of the pill) is calculated. This was determined to be 0.019. The relative standard error for

the base of the proportion (i.e., the estimated total

number of teenage family planning patients) is provided in table II.

Therefore

RSE (946,000)= #(0.O 19)2 + (0.043)2 = 0.047.

The standard error is the aggregate estimate multiplied by the RSE:

Standard error (946,000) =(0.047)(946,000) =44,462

Nonsampling error. –The data presented in this

report are also subject to nonsampling error, including that due to service site nonresponse, item

nonresponse, information incompletely or inaccurately recorded, and processing error.

A major component of nonsampling error is

associated with the gap between the survey sampling

frame and the universe. The frame only partially

covered those sites that had inaugurated the provision

of family planning services since early 1976.

During early 1980 the National Center for Health

Statistics conducted a study to identify and measure

nonsampling error associated with 1980 data from

the National Reporting System for Family Planning

Services.T The study included site visits to 174 family

planning facilities in the 1980 sample. The study

revealed that it was not generally possible to verify

the number of medical family planning visits. For

example, service sites frequently did not differentiate

between medical and nonmedical family planning

visits. The study indicated patient totals are probably

underestimated. Other problems associated with

adherence to survey definitions and procedures were

identified, and evidence suggests that patient data

were not always updated in the site’s record system at

every visit.

Rounding. –Aggregate estimates of family planning patients are rounded to the nearest thousand.

The percentages were computed based on unrounded

estimates; thus, the figures may not add to the totals.

NOTE: A list of references follows the text.

15
Appendix IL Definitions of

terms used in this report

CZinic.–See family planning service site.

Clinic Visit Record. –The primary data collection

form used by the National Center for Health Statistics for the National Reporting System for Family

Planning Services. See appendix III for facsimile.

Contraception. –Conscious use of medication, devices, or practices that permit coitus with reduced

likelihood of conception (commonly known as birth

control).

Contraceptive method. –Any medication, device,

or practice that permits coitus with reduced likelihood of conception.

Education. –The highest grade of “regular” school

completed (not the highest grade entered). “Regular”

school refers to any institution in which a person can

earn credits toward an accredited elementary school

certification, high school diploma, or college degree.

Trade schools, beauty schools, business schools, and

the like are excluded unless credits are granted

toward an elementa~ school certificate, high school

diploma, or college degree.

Family planning patient. A person who receives

medical services related to contraception, sterilization, or infertility treatment in a family planning

service site anywhere within the United States or its

territories.

Family planning service site. –A location providing family planning services on a regular basis under

the supervision of a physician. Private physicians’

offices and group medical practices are excluded

unless they receive a U.S. Department of Health and

Human Services grant for the provision of family

planning services. Military service sites are also excluded from the survey.

Family planning services. –Medical services that

are primarily related to regulation of conception; that

is, they enable a person either to reduce the risk of

conception (contraceptive services) or to induce

conception (infertility services), as desired.

Fetal death. –Death of a product of conception

prior to complete expulsion or extraction from its

mother. This includes miscarriages, stillbirths, and

induced abortions.

Live birth. –A child born alive any time after

conception. In the event of a multiple birth, each

child is counted as one birth. For example, twins

count, as two live births, and triplets count as three

live births.

Medical services. –These include the provision of

contraceptive methods, general physical examinations, and other tests involved in maintaining the

health of the patient. The following services are

included:

Pap smear: Papanicolaou’s test to detect cervical

cancer.

Pelvic exam: Speculum examination of the vagina

and bimanual examination of internal pelvic

organs.

Breast exam: Inspection and palpation of the

breast and axillary glands.

Blood Pressure: Routine measurement of a

patient’s-blood pressure.

Pregnancy testing: Any

to determine pregnancy.

V.D. testing: Test to

venereal disease.

diagnostic test performed

detect the presence of

Urinalysis (n.e.s.):b Any test done on the patient’s

urine sample other than for venereal disease detection or a pregnancy test.

Blood test (n.e.s.) :b Any test of a patient’s blood

except for venereal disease detection or a pregnancy test.

Other medical services: Medical family planning

services not specified on the Clinic Visit Record.

Examples include X-rays and immunizations.

New patients. –All patients whose first visit (i.e.,

initial visit) to a family planning service site occurred

%.e.s. means not elsewhere spectiled.

16
during the survey year. This does not preclude the

individual’s having visited a private physician. Northeast. . . . . .

Public assistance income. –The patient’s family

income includes money from any Federal, State, or North Central. . .

local public assistance program. Scholarships, education grants, unemployment benefits, and Social

Security pensions are not considered public assistance South . . . . . . . . .

income.

Regjon. –Each of the family planning service sites

is classified by location in one of the four geographic

regions of the United States, which correspond to

those used by the U.S. Bureau of the Census. The West . . . . . . . . . .

following framework is used:

Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New

York, New Jersey, and Pennsylvania.

Michigan, Ohio, Illinois, Indianar Wisconsin, Minnesota, Iowa, Missouri, North

Dakota, South Dakota, Nebraska, and

Kansas.

Delaware, Maryland, District of Columbia,

Virginia, West Virginia, North Carolinar

South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi,

Arkansas, Louisiana, Oklahoma, and

Texas.

Montana, Idaho, Wyoming, Colorado, New

Mexico, Arizona, Utah, Nevada, Washing-

,, ...,

ton, Oragon, California, nawall, arm

Alaska.

17
Appendix Ill. Clinic Visit Record

for Family Planning Services

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE

HEALTH RESOURCES ADMINISTRATION

NATIONAL CENTER FOR HEALTH STATISTICS

Clinic Visit Record for Family Planning .%wices

1, SERVICE NUMSER

-

2 “T’ENT”’J”aER ~

N!,, ”..,

3. OATE OF THIS VISIT Qlgn

4. PATI ENT’S SEX

a ❑ Female b D Male

5, ARE YOU OF HISPANIC ORIGIN OR 0ESCENT7

HAND CARD A ● ❑ Yes bnNO

a, PAT IENT’S RACE {Check one box)

b ❑ slack d ❑ Amar!mn tnotan or Alaskan Native

7. WHAT IS YOUR elRTH DATE?

4 Date ~ q Q

a. PATIENT STATUS

Have you ~r been a patient of this or any other clinic ror family

planning M services?

a ❑ Ye, baNO

If ,’Yes;, when were you ~s patlont at a.Y 00

clJnic for famJJy plannhg medical 8orvicm7. _ ~o”th

9. EOUCATION

A. What h the highest cad. (or year) of regular school You hn.m complete<

(Circle one number f

0123456789 10111213141516 17+

(If %ero,”po to 10)

B. .4M YOU presently a student in a res”lar school?

a ❑ Yes

bDNO

10. FAMILY INCOME ANO FAMILY SIZE

HAND CARD Band HANO CARDC

A. Which of the following Exoup# reprem”ta Your total combJned gross

(before deductions) fandJy income for the past 12 months?

●n

0-$1,249 d ❑ $6,250-$8,749 g ❑ $18,750+

b ❑ $1,250.$2,749 e ❑ $8,7s0-$13,7.?9 h ❑ U“know”

c ❑ $3.750-$6,249 f ❑ $13,750-$18,749

B. How mnny people are in your famJJy, that is, the number

supg+rted by this income?

C. Does this i“.mme include any public atdstanm?

D. What k your relationship to the chief earner?

● ❑ Chief earner c ❑ Da. ghtwlso”

b ❑ ‘ife/HusbaOd d ❑ other r.latl..

AGENCY USE ONLY

A B c D E F

1.

2.

3.

4.

5.

6.

AN?

ASSURANCE OF CONFIDENTtA LITV-All In formatlcm Which would P9rmlt ldmtlflcatlcm of an Indlvld. al, a practice, or m establishment will D. held mnftidmtlal,

will be used only by Persons e“gawd in and for me p.nwsm of me survey and WIII

“m be dlsctosea or releasea to cdhm permns or used for my’ Othm purpose. Provlslon

of services Is h! no way Contlngmt cm the Patlent,s Drovldl”q any In forrmtlo” for

this fc.rm.

11. PREGNANCY HISTORY (Females onlyl

A. Hive Yo” ever been preg”a”t?

~ •l yes b lJNO-GOtOIZ

EI. HOWmany !iW birtJu June yOII had?

C. Of them, how many are now livi”g7

D. How many of your prcgm”des were ended by stiObJrth,

induced abortion, or nd.wrlage? (If %ero. ,’go to F )

E. How many of them pre~n.s”clm were ended by induced

abortion since January 197 3?

F. la what month and Yem did Your last pregnancy end

(re@rdJeu of how it ended)? 1

Month Year

12. CONTRACEPTIVE HISTORY

A. Have You ever used ● method of birth control regularly?

a ❑ Yas b ❑ No-Goto 73

HAND CARD D

B. What method did you last use re@arlYl (Check ●ll I?Mfhock thm app$’)

. D .st.r[llzatlm f ❑ Condom

b D Ord (Pill) 9 ❑ Foam/J.llY/Crc.m

c IJ IUD h ❑ Natural (Includlng rhythm)

d ❑ DlaPhragm J ❑ Other

e ❑ lnJectlon

C. Do You currenfJy US. that method (primary method checked in 12B)7

● ❑ w--Go w ~

D ❑ No

I I I

D. 1“ what month and Yem did You stop using that method? +

E. How long did You use that method?

— OJYS [if lass than a month)

— Month$ (If less than a yew)

— v*ars

F. Where wm the method prescribed or obt.ined?

a r-J ‘rM,$arv,c.slt. e ❑ Oruq store (nonpr.scrlotlon)

b a CII”IC (If oth.r than this .IW f ❑ other

c H Haspltal (If Otiwr than this sK*) g ❑ Unknown

d n Rlvat. physlclan

13. MEOICAL SERVICES PROVIOED AT THIS VISIT

a ❑ Pm sm.ar g I_JUrmalyils (n.e.s.)

b ❑ Pmvlc exam n ❑ Blood test [me.%)

c ❑ ❑ast .xmn j rJ Storlllzatlon

d ❑ Blood Dre%ur. k ❑ In f*rtflIty trmatmmt

. ❑ F7.nnanw tasting m ❑ Othar madlcal Service%

f ❑ v.o. tasting

14. CONTRACEPTtVE METHOD AT THE END OF THIS VISIT

A. Method (Chwk ail that aPJJ&]

a I_J St.rlllz.ti.an f ❑ condom

h ~ Oral [Phi) g ❑ Fc.mn/JcllY/Cream

c ❑ IUD h ❑ Natural [including rhythm]

d H Dlcphragm I ❑ other

. ❑ lnJactlon K ❑ Nom

B. If “None,” SJV. muon (Uwck on8 onlv)

a ❑ pregnant d ❑ Othw medical r-sons

b ❑ I“futlllty Patle”t 9 ❑ R.tymg on IXrtnar,s mathod

c ❑ s-king p-gn~n- f ❑ ofh~r

HRA-192-I

8
Vital and Health Statistics series descriptions

SERIESI.

SERIES 2.

SERIES 3.

SERIIES4.

SERIES 10,

SERIES 11

SERIES 12,

SERIES 13,

Programs and Collection Procetlures-Reports ckcrlbmg

the gm’ieral programs of the National Center for Health

Statistics and its offices and divicions and the cfata collection method$ uwd. They also include definitions and

other material necmsary for understanding the data.

Data Evaluation mtd Methods Research .-Stud[es of rwtv

statmtlcal methodology Including experimental tests of

new survey methods, studte$ of vital ztat!stlcs collectlsm

mathod?,, n~v~ analytical techniques, objectwe evaluations

of relmfml[ty of collected data, and contributions to Na -

tiwcal theory.

Analytical and Epidemioiogical Studies. –Reports presenting cmalytfcal or Interpretive studies based on wtal

and health statistms, ccm’ylng the analysis further than

the expository typm of reports m the other serw?..

Documents and Committeo Reports, – Final reports of

major committees concerned with wtal and h,+alth statistics and documents such as recommended model vital

registration lams and revised birth and ch?ath certlf mates.

Data From the NWonal Health Interview Survw/.-Stat!stics on dlnex, accidental Injuries, dmablllty, use of hmpltal, medical, d,mtal, and other serv{ces, and other

health-related top!cs, all based on data collected In the

continuing national houmhoid lntw~.fle~.i surve,; .

Data From the National Health Examination Survey and

the National Health and Nutrition Examination SurvcyData from direct e:.:amlnatlon, tezttng, and measurement

of national samplm of the cw!lmn nonlnstltutl onallzed

popukmon provide the baws for (1) estimates of the

medically defined prevalence of speclflc dlsea~,?~ in the

Umted States and the dlstrlbut!onz of the population

tvlth respect to physical, phys!ologtcal, and pzychoIoglcal charactensttc~ and (2) analys!c of relatlonthlps

among the var!ou$ m~awrement~ \./lthout reference to

an expllclt fmlte unwwse of persoms.

Data From the Institutionalized Population Survey s.-Discontlnued in 1975. Reports from these surveys are included in Series 13.

Data on Health Resources Utilization.–Statistlcs on the

utilization of health manpo~ver and facilities providing

SERIES 14.

SERIES 15.

SERIES 20.

SERIES 21.

SERIES 22.

SERIES 23.

long-term card, ambulatory care, hospital care, and familv

planning W_wc%.

Data on Health Resources: Manpower and Facilities. –

Statmtics on the numlxrs, ~?ographic distribution, and

character mtlcs of health resources includtng phys!clans,

d~ntists, nurzes, other health occupations, hospltal$,

nursing homes, and outpatient facilities.

Data From Special Surveys.-Statistlcs on health and

health-related topics collected In ?.peclal surveys that

are not a part of the continuing data systems of the

National Cent?r for Health Stattst!cs.

Data on Mortality .–Various statistics on mortality other

than as includ?d in regular annual or monthly reports.

Special analys,es by cause of death, age, and other demographic variables; geographic and time series analyses;

and statistics on characteristics of deathc not available

from the vital records bawd on sample surveys of those

records,

Data on Natality, Marriage, and Divorce. –Various statmlcs on natality, marriarj:, and divorce other than as

included m regular annual or monthly reports. Special

anal~:’m b!) demographic var!ables; geographic and time

wrles anal~,~se:<; studiez of fertility; and statistics fin

characteric,tlcz of births not available from the v[tal

records based on sample sun’t?ys of those records.

Data From the National Mortality and Natality Surveys.–

D!scontmued m 1975. Reports from these sample surveys

bas~d on wtal records are Included in Serves 20 and 21,

respect ively.

Data From the National Survey of Family Growth. –

Statistics on fertil[tyr family formation and dissolution,

farnlly planning, and related maternal and infant health

toptcs derived from a periodic survey of a nationwide

probability sample of ew?r-mmried women 1544 years

of aga.

For a list of titles of reports published in these series, write to:

Scientific and Technical Information Branch

National Center for Health Stattstlcs

Public Health S9rvice

Hyattsvilk?, ~:ld. 207~2
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Off Ice of Health Research, Statistics, and Technology

National Center for Health Statistics

3700 East-West Highway

Hyattsville, Maryland 20782

OFFICIAL BUSINESS

PENALTY FOR PRIVATE USE, $300

from the Office of Health Researchr Statstics, and Technology

DHHS Publication No. (PHS) 81-1718, Series 13, No. 57

.

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U.S. DEPARTMENT OF HHS

HHS 396

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m

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for listings of publications in the VITAL AND HEAi_TH STATISTICS series, call 301-436-NCHS