Telehealth for Reproductive Health Services for Economically Disadvantaged Youth

Purpose: There is a lack of studies describing reproductive health service use and outcomes with telehealth in publicly funded clinics in community settings for economically disadvantaged adolescents and young adults (AYA). This study sought to compare use of reproductive health services before and during the COVID-19 pandemic and analyze the types and quality of reproductive health-care services for patients who did and did not complete a telehealth visit.

Methods: Medical records were reviewed for AYA who sought reproductive health services at 9 urban family planning and school-based clinics. Visit-type differences and associated factors by year of service and among those who did and did not complete telehealth visits were analyzed.

Results: Twenty-seven thousand nine hundred sixty-one unique patients were served between 2019 and 2021. As compared to 2019, in 2020 and 2021, there were significantly fewer visits by minors (<18 years old) versus young adults (18-24 years old) (p < .001), and by those with male versus female natal sex (p < .001). At least one telehealth visit was completed by 17.98% of patients. Telehealth visit completion was more likely in young adults, female, Black, non-Hispanic, and higher-income patients. Telehealth users were more likely to complete annual sexually transmitted infection testing, had a higher number of visits per year, and had higher odds of requiring a return visit within 2 weeks of the index visit (odds ratio 1.5, 95% confidence intervals 1.41-1.76).

Discussion: Our findings illustrate disparities in telehealth use in this population of economically disadvantaged AYA and provides pragmatic targets for future interventions.