Abstract
Perceptions concerning long acting reversible contraception among urban minority women
Lori Bilello, PhD, MBA, MHS1, William Livingood, PhD2 and Katryne Lukens Bull, MPH3
(1)University of Florida College of Medicine - Jacksonville, Jacksonville, FL, (2)University of Florida College of Medicine-Jacksonville, Jacksonville, FL, (3)University of North Florida, Jacksonville, FL
APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28)
Objective: Although evidence continues to emerge that Long-acting reversible contraception (LARC) is highly effective in preventing unintended pregnancies, the prevalence of LARC remains low among US women overall, particularly among minority and low-income women. This study was designed to develop insights into factors that can influence urban, predominantly African American women’s decisions to use LARC.
Study Design: Five focus groups with women were conducted in predominantly African American neighborhoods, in conjunction with a community-based organization providing programs for underserved women, in an urban southeastern US city.
Findings: Key insights from the focus group results for healthcare providers include: the importance of framing discussions with patients within the context of the patients’ goals; the need to acknowledge and respect the support systems that women rely on for child birthing and childcare; recognition of the clinician’s role as a trusted and respected source of information; and the need to understand and be prepared to address the inaccurate and misleading information that can interfere with patients’ optimal choices for contraception.
Conclusions: The insights gained from the study reinforce the need for and provides critical insights for delivering patient-centered obstetric care that can lead to better informed patient decision making related to contraception following delivery and prior to discharge. The identified individual issues and concerns regarding contraception in general and LARC, in particular, can pose a substantial barrier to LARC utilization. Enhanced understanding of the issues and concerns of this population can enhance provider-patient health communication, resulting in women making sound choices regarding contraception.
Assessment of individual and community needs for health education Planning of health education strategies, interventions, and programs Provision of health care to the public
Abstract
Young women’s beliefs and attitudes about contraception: A qualitative study for measure development
Isabel Muñoz, MPH1, Lavanya Rao, MPH2, Cynthia Harper, PhD3, Kaitlyn Morrison3, Janette Alvarez, MPH3 and Corinne Rocca, PhD, MPH4
(1)University of California, San Francisco, Oakland, CA, (2)University of California, San Francisco School of Medicine, San Francisco, CA, (3)University of California, San Francisco, San Francisco, CA, (4)University of California, San Francisco School of Medicine, Oakland, CA
APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28)
Individuals’ beliefs and attitudes about contraceptives are essential considerations for their method preferences and use. In order to develop items for a psychometric scale to measure contraceptive beliefs and attitudes, we conducted focus groups and in-depth interviews with 55 sexually-active, cis-gendered women, aged 15-29 years across three California clinics. We asked participants about their knowledge and experiences with birth control, their likes and dislikes, and the impact birth control has on their bodies and lives. We coded transcripts using Atlas.ti and used grounded theory analysis. Participants voiced both negative and positive attitudes about contraception that were rooted in their own experiences and those of peers. Of primacy were frustrations with negative side effects, including moodiness and irregular bleeding, and feelings that birth control is “invasive” or “not natural.” Participants expressed skepticism about long-term safety and fears about future fertility. Views on contraception also reached beyond their own bodies and were situated within a social context of family member and community judgement (“looked down upon,” “oh, she’s really fast”) and financial and structural components of acquiring birth control (“pretty messy trying to acquire it,” “embarrassing”). Critically, participants also verbalized benefits of using contraception across similar domains, including favorable side effects, the benefits of preventing pregnancy (“peace of mind,” “in control,” “go after my dreams”), and positive social perceptions (“being responsible”). Women’s perspectives reveal that a valid measure of contraceptive attitudes, a major component of contraceptive decision-making, must capture concerns, benefits, physical effects, and social meanings.
Public health or related research Social and behavioral sciences
Abstract
Not business as usual: Providing quality, comprehensive same day contraceptive services
Carolina Cid, M.S.1, Tiffany Byrd, MPH, CHES2 and Kate Satterfield, MPH2
(1)Eau Claire Cooperative Health Center, Columbia, SC, (2)New Morning Foundation, Columbia, SC
APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28)
Eau Claire Cooperative Health Center, Inc. (ECCHC) was founded in 1981 with the purpose of addressing the primary health care needs in the Eau Claire community, which was Columbia, South Carolina’s largest underserved collection of low-income neighborhoods. In 1993, ECCHC became a Federally Qualified Health Center, adding OBGYN services in 1997. To date ECCHC has 29 clinics in four counties, offering several specialty services. In 2017, ECCHC became a part of the Choose Well initiative, a statewide contraceptive access initiative, and was able to expand contraceptive services from one site to five. The partnership enabled twenty-two providers to be trained in IUD and Implant placement in 2018, resulting in fourteen providers currently providing those services. In 2018, when a referral linkages workgroup was formed, ECCHC underwent several systems changes to make contraceptive care access easier and more consistent for referred patients. Two key advancements included an adaptation of the scheduling system for contraceptive care patients to allow for same-day insertion of IUDs and Implants, if desired, and establishment of a process to ensure consistent stocking of devices at implementation sites. ECCHC performed 221 IUD and Implant insertions in 2018 and 375 IUD and Implant insertion in 2019. This presentation will highlight how ECCHC created priority appointments for Choose Well contraceptive patients, ensured devices were available at implementation sites, and will detail the best practices for transforming contraceptive care service delivery beyond OBGYN departments in health clinics.
Implementation of health education strategies, interventions and programs Provision of health care to the public Public health or related organizational policy, standards, or other guidelines Public health or related research
Abstract
Making connections to strengthen postpartum contraception
Lynn Secrest, BSN, RNC-OB, FPHW1 and Angela Olawsky, RN, MPH, CPM2
(1)Spartanburg Regional Medical Center, Spartanburg, SC, (2)New Morning Foundation/Choose Well, Columbia, SC
APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28)
Spartanburg, SC is the fifth largest county in South Carolina. Spartanburg Regional Medical Center is the anchor hospital in the county and delivers the majority of babies born. Assuring that women receive postpartum contraception is an ongoing objective for obstetric providers nationally. As a member of the Choose Well initiative since 2017, Spartanburg Regional Medical Center worked to strengthen two key aspects of postpartum care. The first aspect was to incorporate quality contraceptive counseling into their nursing care plan, providing patient-centered counseling at a time important for future birth spacing. The second aspect, working one-on-one with postpartum women to select a contraceptive method prior to discharge, ensures a woman is covered with a method of choice before potential for pregnancy returns. Despite the successful incorporation of these services, a contraceptive access gap remained for women unable to decide on a method before leaving the hospital. Spartanburg Regional sought to narrow this gap by employing an Obstetric (OB) Nurse Navigator whose role focuses on contraceptive counseling and referral linkage for new mothers who leave the hospital without a contraceptive method. The OB Navigator has built success through the development of a diverse referral network, which includes Nurse Family Partnership, Title X Funded County Health Departments, and the local federally qualified health center. Through the utilization of these partners, postpartum women are better able to secure postpartum contraception. This presentation will highlight the importance of establishing relationships with diverse clinical providers in order to work towards women receiving postpartum contraception.
Implementation of health education strategies, interventions and programs Provision of health care to the public Public health or related organizational policy, standards, or other guidelines Public health or related research