The Baylor Teen Health Clinic has provided high quality healthcare in Houston’s inner city neighborhoods to young men and women 13 to 25 years of age since 1971. The size and scope of the clinic has changed with the changing needs of the community but all the while, it has been under the impactful leadership of Dr. Peggy B. Smith, professor of obstetrics and gynecology at Baylor College of Medicine.
Smith says she was in the right place at the right time to establish the clinic. She was teaching at Rice University when she was asked to take over as principal investigator in the fourth year of a five-year study at Baylor looking at why girls get pregnant.
“At the end of the grant, a voice in my head said, ‘This shouldn’t be put to bed,’ and I started seeking additional funding,” Smith recalls. “We continued operating a clinic in Jefferson Davis Hospital and we just kept growing, and now we have multiple clinics with a variety of services to meet the unique challenges and needs of our patients.”
The Baylor Teen Health Clinic today is a system of 10 community and school-based clinics that provide comprehensive medical care, including primary care immunizations, sports medicine services, reproductive care and more, via 30,000 visits to medically underserved and mostly uninsured adolescents and young adults each year. That’s a long way from the one-day-a-week maternity clinic that saw about 200 adolescent patients annually.
“We have grown tremendously, but we stay focused on providing essential care. Our services are not complicated or fancy – we’re doing rapid HIV testing; we’re doing meningitis vaccines, a pre-requisite for all teens to go to college – but with a little effort we are transformational for our patient population,” Smith says.
She has witnessed the changing needs of her patients as well as new trends and behaviors over the years. There has been an overall drop in the pregnancy rate, due in part to long-acting birth control methods and behavioral changes, and also the rise of HIV/AIDS, with new diagnoses at the clinic each year.
Recent societal changes have resulted in the clinic now serving young adults up to age 25. “We are more cognizant that young people between 20 and 25 are not quite grown up. The period of adolescence has essentially been extended and because of that, we now treat patients who are older than the ones we saw when the clinics started.”
Social media has dramatically changed the way young people get their information, and Smith and her staff have had to adapt to this trend. They’ve had success in this area by making use of the web, text messaging and even short videos to get important healthcare messages to their patient population.
Despite these changes, Smith’s goal has remained the same.
“Our goal is to arm our young patients with good information so they can make the right decisions and to provide them a good medical home,” she says. “Under the aegis of Baylor College of Medicine, our patients have access to the best-trained doctors in the world. If the Baylor Teen Health Clinic provides a sports physical, it’s with a board-certified specialist in adolescent sports medicine. If we provide obstetrics care, it’s with a board-certified specialist. Our patients receive the best that the College has to offer in the schools and neighborhoods that need it the most.”
Some highlights of the Baylor Teen Health Clinic include:
- Establishment of medical home clinics for inner city youth in Fifth Ward, Third Ward, Kashmere Gardens, Sunnyside and Acres Home - neighborhoods with high teen pregnancy, sexually transmitted infections and HIV.
- Reduction of teen pregnancy rate at its four established school-based clinics from 2011 to 2014 on average to 5 to 15 percent, depending on the school.
- Provision of state-of-the-art Long Acting Reversible Contraception (LARC) to 1,700 patients in 2014 from 1,300 patients in 2011 at little or no cost to patients.
- Interactive website which receives 1,400 queries a month and answers questions by avatars in 24 hours and links patients to care.
- The expansion of Centering Pregnancy maternity care, which focuses on both mothers and fathers, including education and job-finding services to young men.
- The increase of the Nurse Family partnership staff, which visits the home of young teen moms for a year after delivery.
- Opt out rapid testing in 2014 using fourth-generation antigen technology and increase in screening for HIV screening and treatment from 9,841 youth in 2011 to 19,204 in 2014.
- A 300 percent increase of vaccinations among patients with the greatest uptake for HPV and meningococcal immunizations, which is a prerequisite for college admission.
- The expansion of the Tejano school clinic to provide services to individuals who reside in the East End community.
- The development of a handheld App ‘Hi5 4 Health’ by clinic faculty, which provides information and linkage to care for HIV.