Contraception最新文献

{"title":"Responsive design, local realities: A process evaluation of Family Planning Elevated","authors":"Jami Baayd,&nbsp;Caitlin Quade,&nbsp;Alexandra Gero,&nbsp;Jessica N. Sanders,&nbsp;Rebecca G. Simmons","doi":"10.1016/j.contraception.2025.111277","DOIUrl":"10.1016/j.contraception.2025.111277","url":null,"abstract":"<div><h3>Objectives</h3><div>While the ability of contraceptive initiatives to improve access has been established, less is known about the process of implementing them within health settings. To address this gap, we conducted a process evaluation of Family Planning Elevated (FPE), a statewide contraceptive initiative in Utah.</div></div><div><h3>Study design</h3><div>FPE partnered with 28 clinics to provide no-cost contraceptive care to individuals across Utah. We conducted a mixed methods process evaluation to document how FPE was implemented, how surrounding context affected the implementation, and the mechanisms by which FPE created impact. Our primary data sources were baseline, midline, and endline focus groups with clinic staff, which we analyzed using the Consolidated Framework for Implementation Research and qualitative longitudinal analysis.</div></div><div><h3>Results</h3><div>Our evaluation yielded six themes: Utah’s reproductive health landscape (1) and the Covid pandemic (2) significantly impacted FPE’s implementation, (3) FPE’s adaptability was crucial to successful implementation, (4) structural characteristics of clinics were a common barrier to implementation, (5) clinic partners were motivated to participate in FPE, despite its complexity, because of the benefit to their clients and (6) provider perspectives and organizational culture became more person-centered during FPE.</div></div><div><h3>Conclusions</h3><div>Findings from FPE’s process evaluation point to the importance of designing a program that is adaptable to shifting local, state, and national context, as well as to the unique needs of each clinic. Clinic partners were committed to expanding contraceptive access through FPE, and during their participation, clinic staff’s perspectives shifted towards a more person-centered approach and culture.</div></div><div><h3>Implications</h3><div>Success of this initiative was driven by the ability of the FPE program to tailor the intervention to meet unique clinic and community needs, and by the commitment of clinic partners to expand contraceptive access for their clients.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111277"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402974","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}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(26)00022-3","DOIUrl":"10.1016/S0010-7824(26)00022-3","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111385"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098453","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}

{"title":"State-level policy options for expanding coverage and affordability of over-the-counter contraceptives in the United States","authors":"Adam Sonfield ,&nbsp;Dana Singiser","doi":"10.1016/j.contraception.2025.111250","DOIUrl":"10.1016/j.contraception.2025.111250","url":null,"abstract":"<div><div>The introduction of over-the-counter (OTC) oral contraceptive pills to the U.S. market has the potential to expand contraceptive access. Still, current federal policy sets up a significant barrier by allowing health insurers to require a medically unnecessary prescription as a condition of covering the drug. State policymakers have explored multiple strategies for eliminating or mitigating the coverage barrier for state residents, including those with state-regulated private insurance, Medicaid, and coverage for public employees and students at public universities and colleges. In this commentary, we explain the scope and limits of state authority, provide examples of state actions to expand coverage and access to OTC contraceptives, and describe major considerations for state officials in designing, implementing, and overseeing new policies. These strategies serve as a roadmap for additional states seeking means to expand access to OTC contraception.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111250"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098456","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}

{"title":"Champions of contraceptive care: Lessons learned from a statewide contraceptive access program","authors":"Katharine O. White ,&nbsp;Natasha M. Lerner ,&nbsp;Lillian W. Acton ,&nbsp;Sarah L. Johns ,&nbsp;Sara Erkal ,&nbsp;Elizabeth Raskin ,&nbsp;Elizabeth Janiak","doi":"10.1016/j.contraception.2025.111353","DOIUrl":"10.1016/j.contraception.2025.111353","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Study design</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Implications</h3><div>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.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111353"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859200","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}

{"title":"Practical insights at a critical time: Lessons from Illinois on implementing family planning state plan amendments","authors":"Kai Tao,&nbsp;Katie Thiede,&nbsp;Meg Lassar","doi":"10.1016/j.contraception.2025.111247","DOIUrl":"10.1016/j.contraception.2025.111247","url":null,"abstract":"<div><div>Family planning Medicaid programs via state plan amendments can extend preventative care coverage to broader populations, generate cost savings for states, and safeguard against changes to Title X and to Medicaid and its financing structure. Contraceptive access initiatives, as subject matter experts and coalition builders, are uniquely positioned to serve as “systems orchestrators”, working across “the 4 Ps”—providers, patients, payers, and policymakers—to fulfill the promise of these policies to improve access to critical sexual and reproductive health services. Since 2021, ICAN! has played this role in Illinois. By providing technical assistance to state agencies, developing tailored trainings for diverse audiences of providers working in health center and community-based settings, and engaging patients through culturally responsive public awareness campaigns and digital tools, ICAN! has developed and implemented a family planning state plan amendment that may serve as a model for other states.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111247"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098455","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}

{"title":"Designing and evaluating a statewide person-centered contraceptive access initiative: The PATH4YOU program","authors":"Tracey A. Wilkinson ,&nbsp;Kelly Kean ,&nbsp;Kathleen Wendholt ,&nbsp;Rebecca Evans ,&nbsp;Surya S. Bhamidipalli ,&nbsp;Yan Tong ,&nbsp;Aaron Brehm ,&nbsp;Steven A. Brown ,&nbsp;Cara Berg Raunick ,&nbsp;Maria Fernandez ,&nbsp;Faith Coleman ,&nbsp;Amy Caldwell ,&nbsp;Jeffrey F. Peipert ,&nbsp;Brownsyne Tucker Edmonds ,&nbsp;Caitlin Bernard","doi":"10.1016/j.contraception.2025.111319","DOIUrl":"10.1016/j.contraception.2025.111319","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Study Design</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> &lt; 0.01), while differences by sexual attraction were found with the PCCC (<em>p</em> = 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%) (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Implications</h3><div>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.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111319"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746029","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}

{"title":"Mixed-methods outcomes from a statewide contraceptive access initiative in Missouri: How The Right Time supports access, method availability and patient-centered care","authors":"Emma Pendl-Robinson ,&nbsp;Divya P. Gupta ,&nbsp;Kirstin Palovick ,&nbsp;Ashley Kuykendall ,&nbsp;Michelle Trupiano ,&nbsp;Kendall Dallas ,&nbsp;Megan Simmons ,&nbsp;Grace Perry ,&nbsp;Lauren Tingey ,&nbsp;Victoria Umstattd Cope ,&nbsp;Maggie M. Magee","doi":"10.1016/j.contraception.2025.111283","DOIUrl":"10.1016/j.contraception.2025.111283","url":null,"abstract":"<div><h3>Objectives</h3><div>The Right Time (TRT) is a statewide contraceptive access initiative with a three-pronged approach (supply, demand, and environment) to improve access to information and contraceptive services in Missouri. We evaluated TRT’s supply prong focused on access, method availability, use of methods, and patient-centered care.</div></div><div><h3>Study Design</h3><div>We used a mixed-methods descriptive design at participating TRT health centers that included health center surveys (<em>n</em> = 12), patient clinical encounter data (<em>n</em> = 69,969), patient experience surveys (<em>n</em> = 131) and focus groups (<em>n</em> = 56).</div></div><div><h3>Results</h3><div>There was an increase in the number of contraceptive methods health centers had in stock and could offer the same day between baseline and 18 months. There was a 5.5% point (pp.) increase in TRT patients’ use of any contraceptive method between intake and exit. There was an increase in use of pills (+8.5 pp.), injections (+3.6 pp.), and intrauterine devices (+3.3 pp.) and a decrease in use of condoms (−9.9 pp.) and other non-hormonal methods (+2.8 pp.). In all, 82% of patients rated their provider as “excellent,” and focus group participants reported patient-centered experiences with providers and few access barriers.</div></div><div><h3>Conclusions</h3><div>Findings suggest TRT’s supply prong may be improving access to contraception and contributing to uptake of contraception in the context of patient-centered care. Our mixed-methods approach illustrates how contraceptive access enables patient-centered care and contributes to the literature on statewide contraceptive access initiatives.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111283"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440389","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}

{"title":"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","authors":"Victoria Nichols ,&nbsp;Angela Maske ,&nbsp;Robyn Elliott ,&nbsp;Britt Wahlin ,&nbsp;Kelly Blanchard ,&nbsp;Lee Che P. Leong ,&nbsp;Sally Rafie ,&nbsp;Daniel Grossman ,&nbsp;Lauren Schenk ,&nbsp;Beau Nelson ,&nbsp;Don Downing ,&nbsp;James Lin ,&nbsp;Kelly Cleland ,&nbsp;Janette Robinson-Flint ,&nbsp;Debra Hauser","doi":"10.1016/j.contraception.2025.111348","DOIUrl":"10.1016/j.contraception.2025.111348","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111348"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811939","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}

{"title":"Bridging the gap: How SiX supports U.S. state legislators in transforming research into policy","authors":"Melissa Madera ,&nbsp;Rosann Mariappuram ,&nbsp;Candi Mundon King ,&nbsp;Charlane Oliver ,&nbsp;Julie von Haefen ,&nbsp;Fran Linkin","doi":"10.1016/j.contraception.2025.111249","DOIUrl":"10.1016/j.contraception.2025.111249","url":null,"abstract":"<div><div>The right to contraception has been protected under the U.S. Constitution since the U.S. Supreme Court decisions in <em>Griswold v. Connecticut</em> (1965) and <em>Eisenstadt v. Baird</em> (1972). However, even with these constitutional protections in place, there have been increased direct attacks from conservative state legislators on contraception using state legislation. But state legislators supportive of reproductive health, rights, and justice continue to push forward on proactive progressive legislation and policies that safeguard contraception. The State Innovation Exchange’s (SiX) Reproductive Rights team launched the Reproductive Freedom Leadership Council (RFLC) in 2018 to support state legislators who champion progressive policies focused on reproductive health, rights, and justice with, among other resources, the tracking and translation of scientific research on family planning and sexual, reproductive, and maternal health, and connecting them with the researchers who produce those data. In this commentary, we provide an overview of how state legislators champion progressive contraceptive policies in their states and offer observations on the role of research from state legislators within the RFLC network. Our objective for this commentary is to share best practices and guidance from legislators themselves about how researchers can make their research more accessible to legislators as they push back against conservative attacks on bodily autonomy.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111249"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497808","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}

{"title":"Reshaping access: Community-led action for contraceptive access in rural Appalachian Kentucky","authors":"Alecia Fields ,&nbsp;Kelsie Williams ,&nbsp;Dustin Miracle ,&nbsp;Joanne Brown ,&nbsp;Kyla Preece","doi":"10.1016/j.contraception.2025.111278","DOIUrl":"10.1016/j.contraception.2025.111278","url":null,"abstract":"<div><div>Access to contraception in the United States varies greatly based on geography. In Eastern Kentucky (EKY), access is limited due to geographic isolation, provider shortages, limited transportation and deeply rooted stigma around reproductive health services. All Access Eastern Kentucky (AAEKY) is a community-driven program that focuses on patient and provider education and access to contraception through an innovative no cost mailing system. This commentary reviews the initiative impacts, key insights and lessons learned through clinic and participant surveys. Since 2016, AAEKY has faced a global pandemic, adapted to a quickly changing political landscape, overcome regional flooding and expanded from a 10 county regional focus to a statewide initiative that is helping to reshape how Kentuckians perceive and access contraception.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"155 ","pages":"Article 111278"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433027","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}