Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117566

Lisa Angus, MPH, Womens & Reproductive Health, Oregon Department of Human Services, 800 NE Oregon Street, Suite 850, Portland, OR 97232, 503-731-8450, lisa.angus@state.or.us, Jeanne Atkins, JD, Oregon Democratic Caucus, 1525 Wynwood Avenue, Portland, OR 97225, and Kenneth D. Rosenberg, MD, MPH, Office of Family Health, Oregon Department of Human Services, 800 NE Oregon Street, Suite 850, Portland, OR 97232.

BACKGROUND: When clients wish to delay or avoid childbearing, one of the primary goals of family planning services is to help them adopt a (more) effective method of contraception. We sought to develop an approach for evaluating program performance relative to this objective. METHODS: Based on the typical-use success rates for clients' entry and exit methods of contraception, we created two variables to express the change in contraceptive effectiveness that clients experienced as a result of their visits: a categorical variable (increased effectiveness vs. no change / decreased effectiveness); and a continuous difference variable (exit method effectiveness – entry method effectiveness). We then conducted analyses to compare the two variables and to assess whether visit source of pay or clinic type were associated with clients adopting a more effective method. RESULTS: Controlling for effectiveness of entry method, purpose of visit, and client demographics, those visits that were Medicaid-paid or took place at family planning-specific clinics were associated with clients experiencing increases in contraceptive effectiveness [(source of pay: OR 1.93, 95% CI 1.74 – 2.13 or F(1, 56271) = 23.6, p < .001) (clinic type: OR 1.94, 95% CI 1.81 – 2.09 or F(1, 56271) = 270, p < .001)]. The categorical and continuous variables produced similar overall results, although the final models included some different covariates. CONCLUSIONS: Depending on the audience and desired level of measurement, either the categorical or continuous variable for change in contraceptive effectiveness experienced at a visit would be a useful indicator for family planning program evaluation.

Learning Objectives:

• Identify and evaluate two methods for tracking the impact of family planning visits on the effectiveness of clients’ contraceptive methods.
• Discuss the implications of associations between clinic type, visit source of pay, and contraceptive method switching at family planning visits.

Keywords: Family Planning, Evaluation

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.