IMPACT OF THE CHOOSE WELL INITIATIVE ON CONTRACEPTIVE COUNSELING AND SUBSEQUENT USE

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2025-10-13 DOI:10.1016/j.contraception.2025.111139

MG Smith, S Naz, L Zeng, R Adelli, AJ Khoury

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引用次数: 0

Abstract

Objectives

Choose Well is South Carolina’s statewide contraceptive access initiative implemented from 2017 to 2022 to promote equitable access to contraception without judgment or coercion. We examined this program’s impact on patients’ experiences with contraceptive counseling and subsequent contraceptive use.

Methods

A quasi-experimental design was employed to recruit patients from program-participating clinics across South Carolina, including health department and federally qualified health center clinics, and matched comparison clinics in a peer state. Patients visiting the clinics for a contraceptive appointment were recruited and followed over 24 months. Data were collected about contraceptive experiences (using the validated Person-Centered Contraceptive Counseling scale) and contraceptive use. Generalized estimating equations measured Choose Well’s impact on 1) counseling experiences immediately post-appointment and 2) contraceptive use prior to the appointment and three months later.

Results

A total of 1,086 participants in Choose Well clinics and 1,136 in comparison clinics aged 16-44 were recruited. After we adjusted for differences between the populations, significantly more Choose Well clinic patients reported person-centered contraceptive counseling (60%) than comparison clinic patients (53%; p=0.04). The proportion of Choose Well clinic patients using intrauterine devices (IUDs) increased from 7.6% at pre-counseling to 11.8% at three months post counseling. In contrast, the proportion of comparison clinic patients using IUDs increased from 4.4% to 4.8%. The resulting 3.8 percentage-point difference was statistically significant (p=0.02).

Conclusions

Choose Well clinic patients reported more person-centered counseling and higher rates of IUD use than comparison clinic patients. This program likely increased access to desired contraceptive methods without coercive counseling, highlighting the important role of statewide contraceptive access initiatives.

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择优行为对避孕咨询及后续使用的影响

“选择好”是南卡罗来纳州在全州范围内实施的避孕措施获取倡议，于2017年至2022年实施，旨在促进在没有判断或强迫的情况下公平获得避孕措施。我们检查了这个项目对患者避孕咨询和随后使用避孕药具的影响。方法采用准实验设计，从南卡罗来纳的参与项目的诊所招募患者，包括卫生部门和联邦合格的卫生中心诊所，以及在同级州的匹配比较诊所。研究人员招募了前来诊所接受避孕预约的患者，并对其进行了24个月的随访。收集有关避孕经历（使用经验证的以人为中心的避孕咨询量表）和避孕药具使用的数据。广义估计方程测量了Choose Well对以下方面的影响：1)预约后立即的咨询经历；2)预约前和三个月后的避孕措施使用情况。结果共招募了16-44岁的选择好诊所的1,086名参与者和比较诊所的1,136名参与者。在我们调整了人群之间的差异后，选择好诊所的患者报告以人为中心的避孕咨询（60%）明显多于对照诊所的患者（53%;p=0.04）。选择好门诊患者使用宫内节育器的比例从咨询前的7.6%上升到咨询后3个月的11.8%。相比之下，使用宫内节育器的比较门诊患者比例从4.4%上升到4.8%。由此产生的3.8个百分点的差异具有统计学意义（p=0.02）。结论schoose Well临床患者比对照临床患者有更多以人为本的咨询和更高的宫内节育器使用率。该项目很可能在没有强制咨询的情况下增加了获得所需避孕方法的机会，突出了全州避孕措施的重要作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.