Concerns About the Cost of Contraception Among Young Women Attending Community College

Yarger, Jennifer; Schroeder, Rosalyn; Blum, Maya; Cabral, Marta A.; Brindis, Claire D.; Perelli, Becky; Harper, Cynthia C.

doi:10.1016/j.whi.2021.03.006

Cited by 4 publications

(3 citation statements)

References 24 publications

(25 reference statements)

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“…Affordability of contraception has been shown to be a common concern among young people regardless of their health insurance status, so information on low or no-cost services is important in this age group. 13 During the COVID-19 pandemic, barriers to reproductive health services increased, especially for historically marginalized populations. [54][55][56] While access improved somewhat over time and telemedicine visits increased, challenges remained among young people, including those facing basic needs adversity.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Many come from non-English-speaking households, face economic adversity, and have cost concerns about accessing care. [12][13][14][15] This study examined data from young women, including cisgender and gender non-binary individuals, in community college. By using data from a community setting, this study includes the experiences of young people in need of care who may have not yet sought care in a clinic, unlike a clinic-based sample that would miss them.…”

Section: Introductionmentioning

confidence: 99%

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Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults

Harper,

Yarger,

Mangurian

et al. 2024

Journal of Women's Health

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Background: Symptoms of mental distress increased sharply during the COVID-19 pandemic, especially among older adolescents and young adults. Mental health distress may make it more challenging for young people to seek other needed health care, including contraception. This study explored the association of symptoms of depression, anxiety and stress with delays in getting a contraceptive method or prescription. Materials and Methods:We used data from a supplementary study (May 15, 2020 -March 20, 2023 to a cluster randomized trial in 29 sites in Texas and California. The diverse study sample was community college students assigned female at birth ages 18-29 years (N=1,665 with 7,023 observations over time). We measured the association of depression (CES-D) or anxiety and stress (DASS-21) symptoms with delayed contraceptive care-seeking with mixed effects multivariable regression with random effects for individual and site. We controlled for age and sociodemographic factors important for access to care.Results: Over one-third of participants (35%) reported they delayed getting a contraceptive method they needed. Multivariable regression results showed increased odds of delayed contraceptive care among participants with symptoms of depression (adjusted odds ratio [aOR] 1.58, 95% confidence interval [CI] 1.27-1.96). Likewise, delays were associated with anxiety and stress symptoms (aOR 1.46, 95% CI 1.17-1.82). Adolescents were more likely to delay seeking contraception than young adults (aOR 1.32, 95% CI 1.07-1.63). Conclusions:Results showed a strong association between mental distress and delayed contraception. Interventions are needed to increase contraceptive access for young people delaying care, along with supportive mental healthcare services, including for adolescents who face elevated odds of delay.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults

Harper,

Yarger,

Mangurian

et al. 2024

Journal of Women's Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, even in states with more expansive health coverage policies for both the insured and uninsured, young adults, including students, may still have cost concerns. A study of community college students aged 18–25 in California and Oregon found that nearly half of students were concerned about the cost of contraception, and that the uninsured had the highest cost concerns [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Use of preferred contraceptive method among young adults in Texas and California: A comparison by state and insurance coverage

Hopkins,

Yarger,

Rossetto

et al. 2023

PLoS ONE

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Background Young people’s ability to use their preferred contraceptive method is an indicator of reproductive autonomy and healthcare access. State policies can hinder or facilitate access to a preferred contraceptive method. Objective This study compared use of preferred contraceptive method in Texas and California, states with contrasting health policy contexts that impact health insurance coverage and access to subsidized family planning services. Methods We used baseline survey data from an ongoing cluster randomized controlled trial of sexually active students, assigned female at birth, ages 18–25, at 29 community colleges in Texas and California (N = 1,974). We described contraceptive preferences and use, as well as reasons for nonuse of a preferred method. We conducted multivariable-adjusted mixed-effects logistic regression analyses for clustered data, and then calculated the predicted probability of using a preferred contraceptive method in Texas and California by insurance status. Results More Texas participants were uninsured than Californians (30% vs. 8%, p<0.001). Thirty-six percent of Texas participants were using their preferred contraceptive method compared to 51% of Californians. After multivariable adjustments, Texas participants had lower odds of using their preferred method (adjusted odds ratio = 0.62, 95% confidence interval = 0.48–0.81) compared to those in California. Texas participants in all insurance categories had a lower predicted probability of preferred method use compared to California participants. In Texas, we found a 12.1 percentage-point difference in the predicted probability of preferred method use between the uninsured (27.5%) and insured (39.6%) (p<0.001). Texans reported financial barriers to using their preferred method more often than Californians (36.7% vs. 19.2%, p<0.001) as did the uninsured compared to the insured (50.9% vs. 18.7%, p<0.001). Conclusion These findings present new evidence that state of residence plays an important role in young people’s ability to realize their contraceptive preference. Young people in Texas, with lower insurance coverage and more limited access to safety net programs for contraceptive care than in California, have lower use of preferred contraception. It has become urgent in states with abortion bans to support young people’s access to their preferred methods.

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Use of telemedicine to obtain contraception among young adults: Inequities by health insurance

Yarger,

Hopkins,

Elmes

et al. 2024

Contraception

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Concerns About the Cost of Contraception Among Young Women Attending Community College

Abstract: had full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Cited by 4 publications

References 24 publications

Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults

Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults

Use of preferred contraceptive method among young adults in Texas and California: A comparison by state and insurance coverage

Use of telemedicine to obtain contraception among young adults: Inequities by health insurance

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