Contraceptive Method Use During the Community-Wide HER Salt Lake Contraceptive Initiative

Datos Bibliográficos

ID11034134
AutoresJessica N Sanders (0000-0002-4487-1997, All of the authors are with the Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.), K Myers (0000-0002-5793-669X, University of Utah), Lori M Gawron (0000-0003-4431-9729, All of the authors are with the Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.), Rebecca G Simmons (0000-0003-3516-4585, All of the authors are with the Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.), David K Turok (0000-0002-6289-0542, All of the authors are with the Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.)
Año2018
Volumen108
Número4
Páginas550-556
Fecha de publicación2018-04-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaAmerican Journal of Public Health (JOURNAL)
Identificadores de la revistaISSN: 0090-0036 • E-ISSN: 1541-0048
EditorialAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2017.304299
PMID29470119
OpenAlexW2788204008
IdiomaEN
Citas recibidas12
Referencias citadas23

Objectives. To describe a community-wide contraception initiative and assess changes in method use when cost and access barriers are removed in an environment with client-centered counseling. Methods. HER Salt Lake is a prospective cohort study occurring during three 6-month periods (September 2015 through March 2017) and nested in a quasiexperimental observational study. The sample was women aged 16 to 45 years receiving new contraceptive services at health centers in Salt Lake County, Utah. Following the control period, intervention 1 removed cost and ensured staffing and pharmacy stocking; intervention 2 introduced targeted electronic outreach. We used logistic regression and interrupted time series regression analyses to assess impact. Results. New contraceptive services were provided to 4107 clients in the control period, 3995 in intervention 1, and 3407 in intervention 2. The odds of getting an intrauterine device or implant increased 1.6 times (95% confidence interval [CI] = 1.5, 1.6) during intervention 1 and 2.5 times (95% CI = 2.2, 2.8) during intervention 2, relative to the control period. Time series analysis demonstrated that participating health centers placed an additional 59 intrauterine devices and implants on average per month (95% CI = 13, 105) after intervention 1. Conclusions. Removing client cost and increasing clinic capacity was associated with shifts in contraceptive method mix in an environment with client-centered counseling; targeted electronic outreach further augmented these results

Confidence interval · Contraceptive implant · Environmental health · Family medicine · Family planning · Intervention (counseling) · Logistic regression · Odds ratio · Outreach · Population · Psychological intervention · Staffing · Demography · Global Maternal and Child Health · Internal Medicine · Maternal and Perinatal Health Interventions · Medicine · Nursing · Pharmacy · Reproductive Health and Contraception