Contraception最新文献

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IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2026-02-02 DOI: 10.1016/S0010-7824(26)00022-3

引用次数: 0

Copyright info/Contents 版权信息/内容

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2026-01-07 DOI: 10.1016/S0010-7824(25)00527-X

引用次数: 0

The Focus Forward Oklahoma Program: A description of the planning, development, and implementation of a statewide contraceptive access initiative 重点向前俄克拉何马计划：描述计划，发展，实施全州避孕措施的倡议。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2026-01-06 DOI: 10.1016/j.contraception.2025.111354

Mary Gowin , Elisabeth Ponce-Garcia , Gale Hann , Lauren Oliver , Monica Henning , Katie Smith , Olivia Lust , Sarah Hall , Kathryn Klump , Melissa Eldredge , Rachel Jillson , Alexa Benedict

Objective

Describe the planning, development, and implementation of the Focus Forward Oklahoma Program, a statewide contraceptive access initiative focused on increasing access to the full range of contraceptive options through three strategies: 1) policy change, 2) communication, and 3) workforce development.

Study design

An implementation science framework was used for planning, development, and implementation. Planning and development included four components: 1) establishing an advisory committee, 2) conducting a needs assessment, 3) developing primary strategies, and 4) identifying baseline metrics. Implementation used iterative action cycles to continually assess and adapt implementation to ensure success.

Results

Eighteen policy issues were identified with 14 resolved as of publication. The communication strategy resulted in collaboration among organizations, alignment of priorities, and the development of training materials, guidance documents, and a resource library. Workforce development resulted in 663 clinicians receiving contraceptive access training.

Conclusions

The planning, development, and implementation of the program demonstrates that implementation science-based efforts can produce strategies that address systemic barriers to contraceptive access. Aligning payer policies, coalition-building, and responsive training are all key activities of the program and process adaptations and lessons learned have contributed to the continued viability of the program.

Implications

Increasing contraceptive access requires a multifaceted approach in which key barriers are addressed. Clinicians can contribute to addressing access via their personal practice and through participation in broader programs such as this one.

目标：描述“聚焦前进俄克拉何马州计划”的规划、发展和实施，这是一项全州范围内的避孕措施获取倡议，旨在通过以下三种策略增加获得全方位避孕选择的机会：1)政策变化，2)沟通，3)劳动力发展。方法：采用实施科学框架进行规划、开发和实施。规划和发展包括四个组成部分：1)建立咨询委员会，2)进行需求评估，3)制定主要战略，4)确定基线度量标准。实现使用迭代操作周期来持续评估和调整实现以确保成功。结果：18个政策问题被确定，14个问题在发表时得到解决。沟通策略导致了组织之间的协作、优先级的对齐，以及培训材料、指导文件和资源库的开发。劳动力发展使663名临床医生接受了获得避孕药具的培训。结论：该规划的规划、制定和实施表明，基于科学的实施工作可以产生解决避孕药具获取系统性障碍的战略。调整付款人政策、建立联盟和响应性培训都是该计划的关键活动，过程调整和吸取的经验教训有助于该计划的持续可行性。影响：增加避孕药具获取需要采取多方面的方法，解决主要障碍。临床医生可以通过他们的个人实践和参与更广泛的项目，如本项目，为解决获取问题做出贡献。

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引用次数: 0

Champions of contraceptive care: Lessons learned from a statewide contraceptive access program 避孕护理的冠军：从全州避孕获取计划中吸取的教训。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2025-12-27 DOI: 10.1016/j.contraception.2025.111353

Katharine O. White , Natasha M. Lerner , Lillian W. Acton , Sarah L. Johns , Sara Erkal , Elizabeth Raskin , Elizabeth Janiak

Objective

The Partners in Contraceptive Choice and Knowledge (PICCK) program encouraged improvements in contraceptive access and quality for Massachusetts hospital-based providers. The program employed a champion model, working with individuals at each partner hospital who were committed to implementing a customized version of the PICCK program. We present the facilitators and barriers to uptake of the customized PICCK initiative.

Study design

We conducted 17 semi-structured interviews involving 26 champions from 13 different PICCK partner hospitals. Researchers who were not involved with overall PICCK program implementation conducted the interviews with a guide based on the Consolidated Framework on Implementation Research (CFIR). Interviews were held via telec onferencing, professionally transcribed, and coded independently by three researchers. We used a combination of inductive and deductive thematic analysis.

Results

We identified facilitators and barriers that represented constructs from all 5 CFIR domains. Additionally, we explored four emergent themes: 1) dynamic interplay between internal and external factors; 2) champion self-efficacy to make change; 3) importance of alignment between the program and the hospital; and 4) heterogeneity of willingness to change.

Conclusion

PICCK was an innovative public health program that utilized evidence-based strategies to improve contraceptive quality and access. Interviews with the program champions revealed advantages to using the champion approach, as well as lessons learned that can be used for future statewide initiatives that strive to expand contraceptive access. While PICCK was primarily a hospital-based initiative, findings may be applicable to other clinical settings or access programs that employ a similar champion model.

Implications

A champion model can be an effective way to combine external program resources with institutional knowledge, relationships, and motivation toward implementation of a contraceptive access initiative.

目的：合作伙伴在避孕选择和知识（pick）计划鼓励改善避孕的可及性和质量为马萨诸塞州医院为基础的提供者。该计划采用冠军模式，与每个合作医院的个人合作，他们致力于实施定制版本的pickp计划。我们提出了促进和障碍，以采取定制pick倡议。研究设计：我们进行了17次半结构化访谈，涉及来自13家不同的pick合作医院的26名冠军。没有参与总体pick计划实施的研究人员通过基于实施研究综合框架（CFIR）的指南进行了访谈。访谈通过电话会议进行，由三名研究人员进行专业转录和独立编码。我们采用了归纳和演绎相结合的主题分析。结果：我们确定了代表所有5个CFIR结构域的促进因子和障碍。此外，我们还探讨了四个新兴主题：1)内部和外部因素之间的动态相互作用；2)拥护自我效能感，做出改变；3)项目与医院协调的重要性；4)改变意愿的异质性。结论：pick是一项创新的公共卫生计划，利用循证策略来提高避孕质量和可及性。对项目冠军的采访揭示了使用冠军方法的优势，以及可以用于未来全州范围内努力扩大避孕措施的经验教训。虽然pick主要是一个以医院为基础的倡议，但研究结果可能适用于其他临床环境或采用类似冠军模式的访问计划。意义：冠军模型可以是一种有效的方法，将外部项目资源与机构知识、关系和动机结合起来，以实施避孕措施获取倡议。

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引用次数: 0

Lessons learned from the movement behind the first over-the-counter daily birth control pill in the United States and recommended strategies for implementing full insurance coverage 从美国第一种非处方每日避孕药背后的运动中吸取的教训以及实施全面保险覆盖的建议策略。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2025-12-20 DOI: 10.1016/j.contraception.2025.111348

Victoria Nichols , Angela Maske , Robyn Elliott , Britt Wahlin , Kelly Blanchard , Lee Che P. Leong , Sally Rafie , Daniel Grossman , Lauren Schenk , Beau Nelson , Don Downing , James Lin , Kelly Cleland , Janette Robinson-Flint , Debra Hauser

July 13, 2023, marked a historic day for contraception access when the Food and Drug Administration (FDA) approved the first-ever daily over-the-counter (OTC) oral contraceptive pill (OCP) in the United States. This approval did not happen overnight. It took two decades of research, advocacy, and partnerships led by the Free the Pill coalition (formerly the Oral Contraceptives Over the Counter Working Group). The Free the Pill coalition’s vision for OTC OCPs goes beyond the FDA approval; it also includes efforts to make other types of OCPs available without a prescription in the United States and ensure all forms of OTC contraception are fully covered by insurance without a prescription. This paper captures lessons learned from the movement-driven effort leading to the FDA approval of the first OTC daily OCP in the United States. It also provides recommendations for how to achieve the coalition’s vision for making OTC OCPs equitably accessible and fully covered by insurance without a prescription. Insights shared in this paper were informed by a series of meetings hosted by the David and Lucile Packard Foundation with key members and partners of the Free the Pill coalition in February 2025, a series of convenings of the Free the Pill OTC Coverage Implementation Collaborative hosted in 2023 and 2024, and over 10 years of convenings and collaborative work with state advocates to advance and implement OTC coverage policies.

2023年7月13日，美国食品和药物管理局（FDA）批准了美国有史以来第一个每日非处方口服避孕药（OCP），这是避孕获得的历史性日子。这种批准不是一夜之间发生的。在“免费避孕药联盟”（前身为“非处方口服避孕药工作组”）的领导下，经过了20年的研究、倡导和合作。“解放药丸”联盟对OTC ocp的愿景超越了FDA的批准；它还包括努力使其他类型的ocp在美国无需处方即可获得，并确保所有形式的OTC避孕都在无需处方的保险范围内。本文从运动驱动的努力中吸取了经验教训，导致FDA批准了美国第一个OTC每日OCP。它还就如何实现联盟的愿景提出了建议，即使OTC ocp公平可及，并在没有处方的情况下完全被保险覆盖。David and Lucile Packard Foundation于2025年2月与Free the Pill联盟的主要成员和合作伙伴举行了一系列会议，于2023年和2024年举办了Free the Pill OTC覆盖实施协作组织的一系列会议，以及与各州倡导推进和实施OTC覆盖政策的十多年会议和协作工作，为本文分享的见解提供了信息。

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引用次数: 0

Recommendations for policies enabling pharmacist–prescribed contraceptive services 促进药剂师处方避孕服务的政策建议。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2025-12-19 DOI: 10.1016/j.contraception.2025.111346

Sally Rafie , Jenny L. Newlon , Jennifer A. Campi , Veronica Vernon , Krystalyn Weaver , E. Michael Murphy

Overly prescriptive legislation, regulations, and protocols dictating pharmacists’ scope to prescribe contraception prevent the realization of the full potential benefits of the policy. Despite pharmacists’ interest and willingness to improve patients’ access to contraceptive care, suboptimal or inflexible policies impede implementation. We have compiled policy recommendations that consider barriers and facilitators to implementation of pharmacist-prescribed contraception, including pharmacist training, pharmacy operations, and payment for services. Armed with the recommendations from our commentary, we expect policymakers and advocates for pharmacist-provided services will be better prepared to propose and revise state policies that support implementation of contraceptive services and improve patients’ access.

过度规范的立法、法规和协议规定了药剂师开避孕药具的范围，阻碍了这项政策的全部潜在好处的实现。尽管药剂师有兴趣并愿意改善患者获得避孕护理的机会，但次优或不灵活的政策阻碍了实施。我们编制了政策建议，考虑了实施药剂师处方避孕的障碍和促进因素，包括药剂师培训、药房运营和服务付费。有了我们评论中的建议，我们期望政策制定者和药剂师提供服务的倡导者将更好地准备提出和修订支持实施避孕服务和改善患者获得避孕服务的国家政策。

引用次数: 0

A collective impact approach to contraceptive access: Facilitators, challenges, and lessons learned from the South Carolina Choose Well initiative 获得避孕药具的集体影响方法：促进者、挑战和从南卡罗来纳州选择健康倡议中吸取的教训。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2025-12-15 DOI: 10.1016/j.contraception.2025.111326

Amal J. Khoury , Kate Beatty , Liane Ventura , Amy J. Weber , Rakesh Adelli , Deborah Quesenberry , Michael G. Smith

Objectives

The South Carolina Choose Well contraceptive access initiative is unique in its collective impact approach and inclusion of federally qualified health centers (FQHCs) as the main clinical partner. Collective impact is a collaborative approach for community response to a complex problem based on five principles: common agenda, shared measurement, mutually reinforcing activities, continuous communication, and backbone support. We identify facilitators, challenges, and lessons learned from Choose Well’s implementation to inform future programs.

Study design

We conducted interviews in 2022–2023 with implementing agency (n = 8) and partner FQHC staff (n = 19), mapped interview questions to collective impact principles, and conducted a qualitative content analysis. We triangulated data to integrate experiences with implementation across both groups.

Results

Choose Well successfully implemented most collective impact principles. Facilitators included a shared vision for contraceptive access between the implementing agency and partner FQHCs; a shift to a contraceptive equity lens and funding for a wider range of contraceptive methods; interventions tailored to the local clinic contexts; direct communication through multiple channels; clinic workflow enhancements; and operational support by the implementing agency. Shared measurement lagged due to limited partner involvement in development of shared measures, competing priorities and capacity deficits among FQHCs, limited training on data collection and reporting, and staff turnover.

Conclusions

Collective impact principles can advance contraceptive access initiatives. Lessons learned highlight the importance of bidirectional communication, direct implementation support, collaboration among partner organizations, and tailored implementation strategies. Shared measurement is challenging and requires joint decision-making and capacity building to optimize learning and programmatic improvement.

Implications

This study represents the first examination of collective impact within the context of statewide contraceptive access initiatives. Future initiatives may consider a collective impact approach that fosters bidirectional communication between the backbone organization and partners; collaboration among partners; tailored implementation at the clinic level; and investments to support shared measurement.

目标：南卡罗来纳选择良好避孕措施的倡议是独特的，在其集体影响的方法和包括联邦合格的卫生中心（fqhc）作为主要的临床合作伙伴。集体影响是社区应对复杂问题的一种协作方法，基于五项原则：共同议程、共享测量、相互加强的活动、持续沟通和骨干支持。我们从“选择好”项目的实施中找出了促进因素、挑战和经验教训，为未来的项目提供信息。研究设计：我们在2022-23年对实施机构（n=8）和合作伙伴FQHC工作人员（n=19）进行访谈，将访谈问题映射到集体影响原则，并进行定性内容分析。我们对数据进行三角分析，以整合两组的执行经验。结果：Choose Well成功实施了大多数集体影响原则。促进者包括在执行机构和伙伴家庭卫生保健中心之间就获得避孕药具达成共同愿景；转向避孕公平，并为更广泛的避孕方法提供资金；适合当地诊所情况的干预措施；多渠道直接沟通；诊所工作流程增强；以及执行机构的业务支持。共享测量滞后的原因是合作伙伴参与制定共享测量的程度有限，fqhc之间存在优先事项竞争和能力不足，数据收集和报告培训有限，以及员工流失。结论：集体影响原则可促进避孕措施的可及性。吸取的经验教训强调了双向沟通、直接实施支持、伙伴组织之间的协作以及量身定制的实施战略的重要性。共享度量具有挑战性，需要联合决策和能力建设，以便优化学习和程序性改进。含义：这项研究代表了在全州范围内避孕措施获得倡议的背景下集体影响的第一次检查。未来的举措可以考虑集体影响的方法，促进骨干组织和合作伙伴之间的双向沟通；合作伙伴之间的协作；在诊所层面量身定制的实施；以及支持共享测量的投资。

{"title":"A collective impact approach to contraceptive access: Facilitators, challenges, and lessons learned from the South Carolina Choose Well initiative","authors":"Amal J. Khoury , Kate Beatty , Liane Ventura , Amy J. Weber , Rakesh Adelli , Deborah Quesenberry , Michael G. Smith","doi":"10.1016/j.contraception.2025.111326","DOIUrl":"10.1016/j.contraception.2025.111326","url":null,"abstract":"<div><h3>Objectives</h3><div>The South Carolina Choose Well contraceptive access initiative is unique in its collective impact approach and inclusion of federally qualified health centers (FQHCs) as the main clinical partner. Collective impact is a collaborative approach for community response to a complex problem based on five principles: common agenda, shared measurement, mutually reinforcing activities, continuous communication, and backbone support. We identify facilitators, challenges, and lessons learned from Choose Well’s implementation to inform future programs.</div></div><div><h3>Study design</h3><div>We conducted interviews in 2022–2023 with implementing agency (<em>n</em> = 8) and partner FQHC staff (<em>n</em> = 19), mapped interview questions to collective impact principles, and conducted a qualitative content analysis. We triangulated data to integrate experiences with implementation across both groups.</div></div><div><h3>Results</h3><div>Choose Well successfully implemented most collective impact principles. Facilitators included a shared vision for contraceptive access between the implementing agency and partner FQHCs; a shift to a contraceptive equity lens and funding for a wider range of contraceptive methods; interventions tailored to the local clinic contexts; direct communication through multiple channels; clinic workflow enhancements; and operational support by the implementing agency. Shared measurement lagged due to limited partner involvement in development of shared measures, competing priorities and capacity deficits among FQHCs, limited training on data collection and reporting, and staff turnover.</div></div><div><h3>Conclusions</h3><div>Collective impact principles can advance contraceptive access initiatives. Lessons learned highlight the importance of bidirectional communication, direct implementation support, collaboration among partner organizations, and tailored implementation strategies. Shared measurement is challenging and requires joint decision-making and capacity building to optimize learning and programmatic improvement.</div></div><div><h3>Implications</h3><div>This study represents the first examination of collective impact within the context of statewide contraceptive access initiatives. Future initiatives may consider a collective impact approach that fosters bidirectional communication between the backbone organization and partners; collaboration among partners; tailored implementation at the clinic level; and investments to support shared measurement.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111326"},"PeriodicalIF":2.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Changes in contraceptive services during a statewide initiative to expand patient-centered contraceptive care in Massachusetts 在马萨诸塞州扩大以患者为中心的避孕护理的全州倡议期间，避孕服务的变化。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2025-12-15 DOI: 10.1016/j.contraception.2025.111327

Elizabeth G. Henry , Yasuyo Abe , Emily Decker , Madeline Mador , Lisa LeRoy

Objectives

To evaluate how access to and quality of contraceptive care changed among health centers supported by Upstream USA during a statewide contraceptive access initiative in Massachusetts.

Study design

Our mixed-method study reported on 12 health centers that encompass 63 sites, annually serving 72,225 patients of reproductive age (assigned female at birth, ages 15–44). We examined contraceptive care metrics extracted from electronic health records (EHR) to identify trends in reproductive health screening and contraceptive service provision before and after the intervention. We assessed the quality of contraceptive care through a post visit patient experience survey. Further insights from qualitative implementation reports were integrated to contextualize observed outcomes.

Results

All health centers increased EHR documentation of screening for contraceptive need, and we observed an increase in the provision of contraceptive services from 8.2 to 14.3 per 100 patients of reproductive age. Service rates increased across all method types except for emergency contraception. Service provision increased across sites within health centers, indicating expanded points-of-access for patients. Patient-reported outcome measures indicate high levels of autonomy in method choice during the visit and patient-centeredness of counseling. Factors critical to sustaining practice change included EHR-embedded screening questions, on-site coaching on workflow, using real-time data feedback loops, and securing leadership support for the integration of contraceptive care into routine primary care.

Conclusions

Findings from this study provide empirical evidence of the impact of key interventions of a statewide contraceptive access initiative to expand access to patient-centered contraceptive care within the primary care setting of community health centers.

Implications

This study demonstrated that embedding screening–based contraceptive care workflows into primary care and providing training and technical assistance to strengthen clinic capacity for the provision of all contraceptive method types are feasible strategies that can be used to expand access to high-quality, noncoercive, patient-centered contraceptive care at community health centers.

目的：评估在马萨诸塞州全州避孕措施获取倡议（SCAI）期间，上游美国支持的卫生中心如何获得避孕护理和质量的变化。研究设计：我们的混合方法研究报告了包含63个站点的12个卫生中心，每年服务72,225名育龄患者（出生时指定为女性，年龄15-44岁）。我们检查了从电子健康记录（EHR）中提取的避孕护理指标，以确定干预前后生殖健康筛查和避孕服务提供的趋势。我们通过访问后患者体验调查评估避孕护理的质量。从定性实施报告中获得的进一步见解被整合到观察结果的背景中。结果：所有医疗中心都增加了对避孕需求筛查的电子病历记录，我们观察到每100名育龄患者提供的避孕服务从8.2增加到14.3。除紧急避孕外，所有避孕方法的服务率都有所增加。保健中心内各地点的服务提供增加，表明为患者提供了更多的访问点。患者报告的结果测量表明，在访问和以患者为中心的咨询中，方法选择的自主权很高。维持实践变革的关键因素包括嵌入电子病历的筛查问题、工作流程现场指导、使用实时数据反馈循环，以及确保领导层支持将避孕保健纳入常规初级保健。结论：本研究的结果为SCAI的关键干预措施在社区卫生中心初级保健环境中扩大以患者为中心的避孕护理的影响提供了经验证据。意义声明：本研究表明，将基于筛查的避孕护理工作流程纳入初级保健，并提供培训和技术援助，以加强诊所提供所有避孕方法类型的能力，是可行的策略，可用于扩大社区卫生中心获得高质量、非强制性、以患者为中心的避孕护理。

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引用次数: 0

Designing and evaluating a statewide person-centered contraceptive access initiative: The PATH4YOU program 设计和评估全州以人为中心的避孕措施获取倡议：PATH4YOU计划。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2025-12-09 DOI: 10.1016/j.contraception.2025.111319

Tracey A. Wilkinson , Kelly Kean , Kathleen Wendholt , Rebecca Evans , Surya S. Bhamidipalli , Yan Tong , Aaron Brehm , Steven A. Brown , Cara Berg Raunick , Maria Fernandez , Faith Coleman , Amy Caldwell , Jeffrey F. Peipert , Brownsyne Tucker Edmonds , Caitlin Bernard

Objectives

Develop and implement a statewide contraceptive access initiative in Indiana using a person-centered contraceptive care framework and to evaluate utilization and care quality using the Person-Centered Contraceptive Counseling (PCCC) and shared decision-making (CollaboRATE) measures.

Study Design

We conducted a cross-sectional analysis of program utilization from 2021 to 2024, examining contraceptive method and appointment type by age and geography using rural-urban commuting area (RUCA) codes. Patients opting to participate in the research sample completed surveys on care quality, which were analyzed by program characteristics and participant demographics.

Results

The analytical sample included 2820 participants with a mean age of 27.1 years (range 14–49). Most care (77%) occurred in-person and 87% of Indiana counties were reached. Participants similarly selected short-acting (45%) and long-acting methods (46%). Those in rural/mixed RUCA areas were less likely to choose long-acting contraception (aOR=0.67, 95% CI 0.55–0.83). Among the research sample, 80% reported receiving high quality care (PCCC) and 75% reported the highest level of shared decision-making (collaboRATE). Differences by ethnicity were observed for both measures (p < 0.01), while differences by sexual attraction were found with the PCCC (p = 0.02). In-person participants more often reported the highest PCCC scores (84% vs 78%), while telehealth participants more often reported the highest collaboRATE scores (81% vs. 72%) (p < 0.01).

Conclusions

Our findings from the PATH4YOU program demonstrate that a statewide, person-centered approach can expand contraceptive access broadly while maintaining participant-reported high-quality care. We found important differences by geography, ethnicity, sexual attraction, and care modality, emphasizing the need to tailor strategies to ensure equitable outcomes.

Implications

A statewide contraceptive access initiative in Indiana (PATH4YOU) was designed with a person-centered care framework and provides free, same-day access to comprehensive contraception. Research sample participants reported high-quality contraception counseling and shared decision-making, with differences noted based on ethnicity, sexual attraction and appointment type, but no other demographics.

目标：在印第安纳州使用以人为中心的避孕护理框架制定和实施全州范围的避孕措施，并使用以人为中心的避孕咨询（PCCC）和共同决策（协作）措施评估使用率和护理质量。研究设计：我们对2021-2024年的项目使用情况进行了横断面分析，使用城乡通勤区（RUCA）代码按年龄和地理划分避孕方法和预约类型。选择参与研究样本的患者完成了关于护理质量的调查，并通过项目特征和参与者人口统计数据进行了分析。结果：分析样本包括2820名参与者，平均年龄27.1岁（范围14-49岁）。大多数护理（77%）是亲自进行的，印第安纳州87%的县都得到了治疗。参与者同样选择了短效（45%）和长效（46%）方法。农村/混合RUCA地区的妇女较少选择长效避孕（aOR=0.67, 95% CI 0.55 ~ 0.83）。在研究样本中，80%的人报告接受了高质量的护理（PCCC）， 75%的人报告了最高水平的共同决策（协作）。结论：PATH4YOU项目的研究结果表明，在全州范围内，以人为中心的方法可以在保持参与者报告的高质量护理的同时，广泛扩大避孕药具的可及性。我们发现了地理、种族、性吸引力和护理方式的重要差异，强调需要量身定制策略以确保公平的结果。启示：印第安纳州的一项全州范围内的避孕措施获取倡议（PATH4YOU）是以人为中心的护理框架设计的，并提供免费的，当天的全面避孕措施。研究样本参与者报告了高质量的避孕咨询和共同决策，根据种族、性吸引力和预约类型发现了差异，但没有其他人口统计数据。

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引用次数: 0

Incoming Editor-in-Chief statement 即将到来的总编辑声明。

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception

Pub Date : 2025-12-08 DOI: 10.1016/j.contraception.2025.111318

Blair G. Darney

引用次数: 0