印第安纳州通过 PATH4YOU 计划制定的避孕药具使用指标:初步审查

Molly Ruggles, Kathleen Wendholt, Caitlin Bernard
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摘要

目标-PATH4YOU 是印第安纳州首个全州范围内的避孕药具获取项目,该项目采用生殖正义框架,通过面对面访问和远程医疗访问提供避孕药具获取服务。我们的目标是对 PATH4YOU 计划的成果进行评估,以确定避孕药具在印第安纳州人群中的分布情况。研究设计--我们分析了 2021 年 9 月至 2023 年 6 月期间接受 PATH4YOU 计划治疗的育龄人群的计划数据。所有参与者都接受了怀孕意向筛查、全面的避孕咨询和决策支持,并获得了免费的避孕方法,包括长效可逆避孕法(LARC)。我们使用描述性统计方法评估了年龄、地点(县)、接受的主要避孕方法、访问过的伴侣网站以及亲自访问与远程医疗访问类型。我们还利用地理地图分析来确定印第安纳州受 PATH4YOU 计划影响最大的地区。结果--在 2021 年 9 月至 2023 年 6 月期间,共有 1,024 人通过 PATH4YOU 计划接受了 1,231 次就诊。参与者的平均年龄为 27.6 岁。很大一部分参与者(49.3%)居住在马里恩县。最常见的主要避孕方法是皮下埋植(25.8%)、避孕药(20.5%)和宫内节育器(16.0%)。访问最多的合作站点包括印第安纳波利斯的人民健康中心(24.8%)和远程医疗(22.5%)。大多数人都是通过一次上门服务(66.0%)或远程医疗(17.9%)获得避孕药具的。结论--PATH4YOU 全州避孕药具获取项目通过上门服务和远程医疗服务为印第安纳州多个县的广大群众提供了一系列避孕方法。启示--PATH4YOU 采用亲临现场和远程医疗访问的独特护理模式是一种新颖的方法,可在一个获得传统亲临现场避孕护理的机会极不稳定的州提高避孕普及率。有必要开展进一步研究,以评估该计划对少数民族和传统上被排斥人群的直接影响,从而评估孕产妇死亡率等长期结果。
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Indiana Contraceptive Use Metrics through PATH4YOU Program: Initial Review
Objective—PATH4YOU is Indiana’s first state-wide contraceptive access project and provides contraceptive access via in-person and telehealth visits using a reproductive justice framework. Our objective was to evaluate outcomes of the PATH4YOU program to determine the distribution of contraceptive access among people in Indiana. Study Design—We analyzed programmatic data of reproductive-age people who received care in the PATH4YOU program from September 2021 to June 2023. All participants received pregnancy intention screening, comprehensive contraceptive counseling and decision support, and no-cost contraceptive method access, including long-acting reversible contraception (LARC). We evaluated age, location (county), primary method of contraception received, partner site visited, and in-person vs telehealth visit type using descriptive statistics. Geographical mapping analysis was used to determine areas of Indiana most impacted by the PATH4YOU program. Results—Between September 2021 and June 2023, 1,024 people received care at 1,231 visits through the PATH4YOU program. The average age of participants was 27.6 years old. A significant (49.3%) proportion of the participants live in Marion County. The most common primary methods of contraception were the implant (25.8%), contraceptive pills (20.5%), and intrauterine devices (16.0%). The most visited partner sites included People’s Health Center in Indianapolis (24.8%) and via telehealth (22.5%). Most people received contraceptive access in one in-person (66.0%) or telehealth (17.9%) visit. Conclusion—The PATH4YOU state-wide contraceptive access project provided a range of contraceptive methods via both in-person and telehealth visits to a wide reach of people across multiple counties in Indiana. Implications—The unique PATH4YOU model of care using both in-person and telehealth visits is a novel way to increase contraceptive access throughout a state with highly variable access to traditional in-person contraceptive care. Further research is necessary to evaluate direct impacts of the program on minoritized and traditionally excluded populations to evaluate long-term outcomes like maternal mortality.
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