Background and Objectives: Reproductive Health Education In Family Medicine(RHEDI) supports family medicine residency programs to establish a required rotation in sexual and reproductive health (SRH), including abortion. We evaluated long-term training effects by examining the practice patterns of family physicians 2 to 6 years after residency graduation, to determine whether and how the practices and abortion provision of those with enhanced SRH training differ from those who did not receive this training. Methods: We invited 1,949 family physicians who completed residency training between 2010 and 2018 to complete an anonymous online survey about residency training and current provision of SRH services. Results: We received 714 completed surveys, a 36.6% response rate. Of those who received routine abortion training during residency (n=445), 24% had provided abortion after graduation, significantly more than the 13% providing abortion who had not received routine training during residency, and much higher than the 3% provision rate found in a recent representative study. Abortion-trained respondents were also more likely than the comparison group to have provided other SRH care. For both medication and procedural abortion, respondents who trained in the family medicine setting were significantly more likely to have provided abortion after residency than those who trained only in dedicated abortion clinics (31% vs 18%, and 33% vs 13%, respectively). Conclusions: Abortion training during family medicine residency is strongly linked to postresidency abortion provision, and is crucial in preparing family physicians to meet the full range of their patients’ reproductive health care needs.

Background and Objectives: Family physicians (FPs) are well positioned to increase abortion access given their broad scope and diverse geographic practice regions. Previously published studies focus on physicians who received formal abortion training but do not include the full landscape of FPs performing abortions in the United States. This secondary data analysis presents a unique opportunity to examine characteristics of early-career FPs who provide abortions, including practice locations and if they received abortion training during residency. Methods: We analyzed data from the 2016-2018 Family Medicine National Graduate Survey to generate descriptive statistics about respondents who report providing pregnancy termination, uterine aspiration/dilation and curettage, or both. We evaluated associations between physician and/or practice characteristics and providing pregnancy termination using bivariate statistics. Results: Of the 6,319 survey respondents, 3% reported providing pregnancy termination. Nearly three-quarters of this subset reported graduating residency feeling prepared to provide pregnancy termination. Most respondents completed residency in the West or Northeast US geographic regions, and 3 years later were practicing in the West or South regions. Additional characteristics associated with providing pregnancy termination include female gender, providing continuity care, and practicing in either an academic medical center or a federally qualified health center. Conclusions: FPs are well positioned to address gaps in abortion access, and those who provide pregnancy termination practice in various US geographic regions. This is the first discussion of its kind about the scope of family physicians providing abortion care. Future research should continue to characterize FPs who provide abortions to determine where they train and practice and what type of abortions they provide.

Limited research exists on the slut labeling process, a key means of enforcing rules around appropriate female sexuality. This study explores that process through qualitative interviews with 44 adolescent girls in Travis County, Texas. Labeling girls as sluts or hos was pervasive and was based on a number of factors beyond sexual behavior, including dress, friendships with boys, or jealousy from other girls. Responses depicted a narrow space in which girls functioned, bound at one end by limited agency and at the other by pervasive vulnerability. There was consensus about the negative consequences of being labeled. Most girls held mixed opinions about the slut labeling process: this may reflect their attempts to push back against a system that entraps them. These findings suggest that prevention and sex education programs must explicitly address slut labeling as well as other gender narratives that impede healthy sexual development.

Although some family medicine residency programs include routine opt-out training in early abortion, little is known about abortion provision by trainees after residency graduation. A better understanding of the barriers to and enablers of abortion provision by trained family physicians could improve residency training and shape other interventions to increase abortion provision and access. METHODS: Twenty-eight U.S. family physicians who had received abortion training during residency were interviewed in 2017, between two and seven years after residency graduation. The doctors, identified using databases of abortiontrained physicians maintained by residency programs, were recruited by e-mail. In phone interviews, they described their postresidency abortion provision experiences. All interviews were transcribed, coded and analyzed using Dedoose, and a social-ecological framework was employed to guide investigation and analysis. RESULTS: Although many of the physicians were motivated to provide abortion care, only a minority did so. Barriers to and enablers of abortion provision were found on all levels of the social-ecological model-legal, institutional, social and individual-and included state-specific laws and restrictions on federal funding; religious affiliation or policies prohibiting abortion within particular health systems; mentorship, colleagues' support and the stigma of being an abortion provider; and geographic location, time management and individuals' prioritization of abortion provision. CONCLUSIONS: Clinical training alone may not be sufficient for family medicine physicians to overcome the barriers to postresidency abortion provision. To increase abortion provision and access, organizations and advocates should work to strengthen enablers of provision, such as strong mentorship and support networks.

BACKGROUND With recent recommendations from professional organizations, long‐acting reversible contraception (LARC) methods are considered appropriate first‐line contraception for adolescents. Many school‐based health centers (SBHCs) in New York City (NYC) have recently added onsite LARC insertion and management to their contraceptive options. We aimed to explore key elements needed to implement LARC training and services into the SBHC setting and to identify successful factors for program implementation. METHODS Semistructured qualitative interviews were conducted with 19 providers and staff at 7 SBHCs in high schools in the Bronx and analyzed using Dedoose. RESULTS Support and leadership from administration; comprehensive onsite training of providers and staff; developing an effective staffing model for procedure sessions; and patient‐centered contraceptive counseling were 4 key themes named by respondents as crucial to the program implementation process. CONCLUSIONS Integrating LARC services onsite at SBHCs is feasible and positively received by providers and staff. With good leadership, staffing, training, and appropriate contraceptive counseling, both SBHCs and other primary clinics that serve adolescents can integrate LARC insertion, removal, and management into routine contraceptive care. This in turn can increase youth access to these methods.