“选择良好的避孕方法获取倡议”对参加南卡罗来纳州医疗补助计划的妇女使用方法的影响:一项中线评估。

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2023-11-01 DOI:10.1016/j.whi.2023.07.003
Nathan Hale PhD , Wondimu S. Manalew PhD , Edward Leinaar MPH , Michael Smith DrPH , Bisakha Sen PhD , Amal Khoury PhD
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引用次数: 0

摘要

导语:从2017年开始,南卡罗来纳州在全州范围内实施了一项为期六年的避孕药具获取倡议,重点是公平获得避孕药具、消除成本障碍、能力建设和培训、提高消费者意识以及扩大安全网诊所的避孕护理。这项研究评估了在“选择好”计划的前三年,参加南卡罗来纳医疗补助计划的妇女避孕方法使用的变化。方法:回顾性分析2012年至2020年在南卡罗来纳州医疗补助计划登记的15至45岁女性的避孕使用情况。采用中断时间序列回归分析评估2012 - 2016年和2017 - 2020年期间宫内节育器(iud)和避孕植入物使用的变化。对所有女性进行了分析,并按年龄组分层。结果:长效可逆避孕方法的使用从预选井期间的8.5%增加到预选井期间的10.9% (p)。结论:在预选井评估的中点,宫内节育器方法的使用明显增加,超出了预选井趋势持续的预期。这在20至25岁的妇女中尤为明显。这些发现表明,“选择好”计划成功地减少了使用宫内节育器的障碍。
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Impact of the Choose Well Contraceptive Access Initiative on Method Use Among Women Enrolled in South Carolina's Medicaid Program: A Mid-line Assessment

Introduction

A six-year statewide contraceptive access initiative focused on equitable access to contraception, removing cost barriers, capacity building and training, raising consumer awareness, and expanding contraceptive care at safety net clinics was implemented in South Carolina beginning in 2017. This study assessed changes in contraceptive method use among women enrolled in the South Carolina Medicaid program during the first three years of Choose Well.

Methods

Contraception use among a retrospective cohort of women aged 15 to 45 enrolled in South Carolina Medicaid from 2012 to 2020 was examined. Interrupted time series regression analysis was used to assess changes in the use of intrauterine devices (IUDs) and contraceptive implants between 2012 and 2016 and 2017 and 2020. Analyses were conducted for all women and stratified by age groups.

Results

Long-acting reversible contraception use increased from 8.5% during the pre-Choose Well period to 10.9% during the Choose Well period (p < .001), with IUD use increasing from 4.3% to 5.2% (p < .001) and implant use increasing from 4.6% to 6.0% (p < .001). The interrupted time series analysis found a significant positive change in the average level of monthly IUD use after Choose Well began (0.493 percentage points; 95% confidence interval, 0.311–0.675). The effect was stronger among women 20 to 25 years of age. Choose Well significantly increased the trend in IUD use among all women by a positive 0.013 percentage points (95% confidence interval, 0.006–0.020) per month beyond expected values.

Conclusions

At the mid-point of the Choose Well Evaluation, the use of IUD methods increased significantly beyond what would be expected had pre-Choose Well trends continued. This was particularly evident among women 20 to 25 years of age. These findings suggest that Choose Well succeeded in reducing barriers to the use of IUDs.

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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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