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

Sanders, Jessica N.; Myers, Kyl; Gawron, Lori M.; Simmons, Rebecca G.; Turok, David K.

doi:10.2105/ajph.2017.304299

Cited by 49 publications

(48 citation statements)

References 26 publications

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“…Details on the initiative, including clinic services and data collection protocols, have been previously reported [15]. Over the 18-month enrollment period (6-month control period and 12-month intervention), a total of 11,509 individuals presented to receive new contraceptive services at HER-participating health centers and 38% enrolled in the survey-arm (n=4,425 for all enrollment periods combined, n=3,704 for the no-cost intervention periods).…”

Section: Methodsmentioning

confidence: 99%

“…While this information can a inform a client’s decisionto initiate a specific method, that decision is entirely theirs to make [14]. Rooted in client-centered counseling, the HER Salt Lake Contraceptive Initiative did not specifically seek to increase use of a particular type of contraceptive method, but did find a shift toward more effective methods after the removal of costs [15]. In this analysis, we explore women’s responses to the survey adapted PATH questions about attitudes towards a hypothetical pregnancy, pregnancy timing, and importance of pregnancy prevention and test associations with contraceptive method selection.…”

Section: Introductionmentioning

confidence: 99%

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Beyond intent: exploring the association of contraceptive choice with questions about Pregnancy Attitudes, Timing and How important is pregnancy prevention (PATH) questions

et al. 2019

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Beyond intent: exploring the association of contraceptive choice with questions about Pregnancy Attitudes, Timing and How important is pregnancy prevention (PATH) questions

et al. 2019

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“…Still, it is possible that a decline in contraceptive failures could have reduced the incidence of unintended pregnancy. Additionally, statelevel efforts to increase access to long-acting reversible contraceptive methods [33][34][35] may have had a measurable impact, particularly in states with higher-than-average abortion rates.…”

Section: Changes In Clinic Numbers Abortion Rates and Policy Contextmentioning

confidence: 99%

Abortion Incidence and Service Availability in the United States, 2017

Jones¹,

Witwer²,

Jerman³

2019

140

143

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This study used new data from the Guttmacher Institute to examine trends in abortion incidence and rates between 2014 and 2017. In addition, we examined changes in the number of health care facilities that provide abortions. ■ ■ In 2017, an estimated 862,320 abortions were provided in clinical settings in the United States, representing a 7% decline since 2014 and the continuation of a long-term trend. ■ ■ The U.S. abortion rate dropped to 13.5 abortions per 1,000 women aged 15-44 in 2017, the lowest rate recorded since abortion was legalized in 1973. Abortion rates fell in most states and in all four regions of the country. ■ ■ A total of 339,640 medication abortions occurred in 2017-about 39% of all abortions. ■ ■ As in previous years, clinics provided the overwhelming majority of U.S. abortions (95%), while private physicians' offices and hospitals accounted for 5%. ■ ■ In 2017, 808 clinic facilities provided abortions, a 2% increase from 2014. However, regional and state disparities in clinic availability grew more pronounced; the number of clinics increased in the Northeast and the West, by 16% and 4% respectively, and decreased in the Midwest and the South, by 6% and 9%, respectively. ■ ■ Although the number of state abortion restrictions continued to increase in the Midwest and South between 2014 and 2017, these restrictive policies do not appear to have been the primary driver of declining abortion rates. There was also no consistent relationship between increases or decreases in clinic numbers and changes in state abortion rates. ■ ■ Fertility rates declined in almost all states between 2014 and 2017, and it is unlikely that the decline in abortion was due to an increase in unintended births. ■ ■ Factors that may have contributed to the decline in abortion were improvements in contraceptive use and increases in the number of individuals relying on self-managed abortions outside of a clinical setting.

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“…Data come from the survey arm of the HER Salt Lake Contraceptive Initiative (HER Salt Lake), a prospective cohort study nested in a quasi-experimental observational study [18]. The primary objective of HER Salt Lake was to assess method use (both uptake and method switching) when cost and access barriers were removed in an environment with client-centered counseling.…”

Section: Methodsmentioning

confidence: 99%

One in three: challenging heteronormative assumptions in family planning health centers

et al. 2018

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Objectives: To estimate the prevalence of sexual-minority women among clients in family planning centers and explore differences in LARC uptake by both sexual identity (i.e., exclusively heterosexual, mostly heterosexual, bisexual, lesbian) and sexual behavior in the past 12 months (i.e., only male partners, both male and female partners, only female partners, no partners) among those enrolled in the survey arm of the HER Salt Lake Contraceptive Initiative. Methods: This survey categorized participants into groups based on reports of sexual identity and sexual behavior. We report contraceptive uptake by these factors, and we used logistic and multinomial logistic models to assess differences in contraceptive method selection by sexual identity and behavior. Results: Among 3901 survey respondents, 32% (n=1230) identified with a sexual-minority identity and 6% had had a female partner in the past 12 months. By identity, bisexual and mostly heterosexual women selected an IUD or implant more frequently than exclusively heterosexual women and demonstrated a preference for the copper T380 IUD. Exclusively heterosexual and lesbian women did not differ in their contraceptive method selection, however, by behavior, women with only female partners selected IUDs or implants less frequently than those with only male partners. Conclusion: One in three women attending family planning centers for contraception identified as a sexual minority. Sexual-minority women selected IUDs or implants more frequently than exclusively heterosexual women. Implications: Providers should avoid care assumptions based upon sexual identity. Sexual-minority women should be offered all methods of contraception and be provided with inclusive contraceptive counseling conversations.

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

Abstract: 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.

Cited by 49 publications

References 26 publications

Beyond intent: exploring the association of contraceptive choice with questions about Pregnancy Attitudes, Timing and How important is pregnancy prevention (PATH) questions

Beyond intent: exploring the association of contraceptive choice with questions about Pregnancy Attitudes, Timing and How important is pregnancy prevention (PATH) questions

Abortion Incidence and Service Availability in the United States, 2017

One in three: challenging heteronormative assumptions in family planning health centers

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