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We assessed the impact of youth-friendly health services (YFHS) on pregnancy risk among AGYW who participated in the Girl Power study. In 2016, Girl Power randomly assigned 4 government-run health centers in Lilongwe, Malawi, to provide a standard (n\u00a0=\u00a01) or youth-friendly (n\u00a0=\u00a03) model of service delivery. At 6 and 12\u00a0months, study participants (n\u00a0=\u00a0250 at each health center) self-reported their current pregnancy status and received a urine pregnancy test. Because of missing pregnancy test results, we used multiple imputation to correct for outcome misclassification in self-reported pregnancy status and applied the parametric g-formula on the corrected data to estimate the effect of YFHS on the 12-month risk of pregnancy. After correcting for outcome misclassification, the risk of pregnancy under the scenario where all health centers offered YFHS was 15.8% compared to 23.2% under the scenario where all health centers offered standard of care (risk difference: \u20137.3%; 95% CI, \u201315.5% to 0.8%). Access to a model of YFHS that integrates provider training with youth-friendly clinic modifications and community outreach activities may decrease risk of pregnancy among AGYW relative to standard of care.<\/jats:p>","DOI":"10.1093\/aje\/kwae193","type":"journal-article","created":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T16:33:58Z","timestamp":1720283638000},"page":"1200-1207","source":"Crossref","is-referenced-by-count":3,"title":["The effect of youth-friendly health services on risk of pregnancy among adolescent girls and young women in Lilongwe, Malawi: a secondary analysis of the Girl Power\u2013Malawi study"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8679-642X","authenticated-orcid":false,"given":"Lauren A","family":"Graybill","sequence":"first","affiliation":[{"name":"Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill , Chapel Hill, NC 27599 ,","place":["United 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University of North Carolina at Chapel Hill , Lilongwe 207233 ,","place":["Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhrutika","family":"Vansia","sequence":"additional","affiliation":[{"name":"UNC Project-Malawi, University of North Carolina at Chapel Hill , Lilongwe 207233 ,","place":["Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1435-8455","authenticated-orcid":false,"given":"Benjamin H","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill , Chapel Hill, NC 27599 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of North Carolina at Chapel Hill , Chapel Hill, NC 27599 ,","place":["United 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