Contraception最新文献

{"title":"MEASUREMENT THAT MATCHES OUR VALUES: PERSON-CENTERED MEASUREMENT OF A PERSON-CENTERED CONTRACEPTIVE INITIATIVE","authors":"J Baayd,&nbsp;C Quade,&nbsp;A Gero,&nbsp;RG Simmons","doi":"10.1016/j.contraception.2024.110566","DOIUrl":"10.1016/j.contraception.2024.110566","url":null,"abstract":"<div><h3>Objectives</h3><div>We conducted a process evaluation of Family Planning Elevated (FPE), a multi-year initiative to improve contraceptive access across Utah by supporting 28 healthcare clinics to deliver person-centered, no-cost contraception. The goal of the process evaluation was to understand not only <em>if</em> FPE was successful, but also <em>how</em> and <em>why</em> it was successful.</div></div><div><h3>Methods</h3><div>Our mixed- methods study combined traditional evaluation metrics (client exit surveys, focus groups with participants, service delivery data) with innovative methods designed to measure shifts towards person-centered care (simulated patient visits with clinic sites, regular reflections with FPE staff, and comparisons of providers’ language over time). Qualitative findings were analyzed using a longitudinal analysis approach and mapped onto the Consolidated Framework for Implementation Research to identify barriers and facilitators to implementation.</div></div><div><h3>Results</h3><div>Our process evaluation detected a shift in healthcare providers’ perspectives about the goal of contraceptive visits: from a focus on matching patients to the “most effective method” to an understanding of how to support patients in finding their individual “best fit method.” Our data show the primary cause of this shift was the many in-person, tailored trainings and proctoring opportunities offered by FPE. Another important component of FPE’s success was the ability to adapt the intervention to meet the specific needs of each clinic partner.</div></div><div><h3>Conclusions</h3><div>FPE was most successful when the intervention adapted to meet the unique needs of healthcare teams and their clients. We learned that supporting clinics in delivering truly person-centered contraceptive care means we must provide clinic staff with programmatic support that is itself person-centered.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426185","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":"RESTRICTIVE ABORTION POLICIES ARE ASSOCIATED WITH INDIVIDUAL RISK OF DIVORCE","authors":"BG Everett,&nbsp;Z Bergman,&nbsp;J Sanders","doi":"10.1016/j.contraception.2024.110568","DOIUrl":"10.1016/j.contraception.2024.110568","url":null,"abstract":"<div><h3>Objectives</h3><div>Multiple studies have documented the benefits of abortion access to women across multiple dimensions. Much less research, however, has examined the broader implications of abortion access to family-level processes. We hypothesize that reproductive autonomy is foundational for family stability and test whether there is an association between abortion-restrictive environments and the risk of divorce.</div></div><div><h3>Methods</h3><div>Data come from the National Longitudinal Study of Adolescent to Adult Health, a prospective cohort data set with five waves of data collection over more than 20 years (n=5,184). The data include multiple indicators of abortion policy and access (eg, public funding available, informed consent procedures, parental consent, and presence of a family planning provider in the county) and relationship histories, including whether the respondent has had a divorce. We used logistic regression analyses and adjusted for sociodemographic characteristics associated with divorce risk (eg, age, education, income, race/ethnicity, number of children in household) and multiple county- and state-level sociodemographic indicators.</div></div><div><h3>Results</h3><div>Respondents who lived in states and counties with more abortion restrictions had an increased risk of being divorced (OR=1.12, 95% CI=1.05, 1.20) in the fully adjusted models. We did not find differences by gender in the relationship between abortion policy and divorce risk.</div></div><div><h3>Conclusions</h3><div>Abortion-restrictive environments are associated with an increased risk of divorce.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426187","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":"DEVELOPMENT AND ASSESSMENT OF A NOVEL SIMULATION FOR ULTRASOUND-GUIDED FAMILY PLANNING INJECTION PROCEDURES","authors":"S Amaya,&nbsp;R Mohty,&nbsp;EP Cahill","doi":"10.1016/j.contraception.2024.110631","DOIUrl":"10.1016/j.contraception.2024.110631","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to create and evaluate a simulation for ultrasound-guided family planning injection procedures including feticidal injections.</div></div><div><h3>Methods</h3><div>We created a simulation model with a gelatin mold containing water balloons. All participants completed a pre-simulation survey regarding previous training and current practice with US-guided procedures. Participants then completed a didactic session on feticidal injections and ultrasound-guided procedure principles. Participants oriented to the simulation tasks and completed three attempts to identify target and place needle into the target to withdraw/inject. They were evaluated on successful completion as well as: correct probe positioning, lining up target, early visualization of needle, needle visualization throughout the entire task, and time to completion. Participants completed a post-simulation survey evaluating the simulation and its impact on their practice.</div></div><div><h3>Results</h3><div>Seven participants completed the simulation: four Complex Family Planning (CFP) Attendings, two CFP fellows and one third year obstetrician gynecologist (Ob-Gyn) resident. In the pre-simulation survey, ultrasound-guided procedures were reported as part of the current practice for all participants except the resident. During the simulation itself, participants reliably completed all tasks successfully. The range of time for task completion varied from 16 seconds to 180 seconds and was notable for the deeper balloons being more challenging to access quickly. In the post-simulation survey, all participants rated the course as excellent, and agreed that they felt more comfortable offering US guided injections as part of their practice after this course.</div></div><div><h3>Conclusions</h3><div>We have constructed a didactic simulation that incorporates the core skills necessary for providing safe ultrasound-guided family planning procedures, including feticidal injections.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426200","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":"BY ADOLESCENTS, FOR ADOLESCENTS: CO-CREATING ‘FIRST STEPS,’ A MESSAGING TOOLKIT TO IMPROVE ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH SERVICES AND EDUCATION","authors":"L Gerchow,&nbsp;Y Lanier,&nbsp;A Fayard,&nbsp;A Squires","doi":"10.1016/j.contraception.2024.110642","DOIUrl":"10.1016/j.contraception.2024.110642","url":null,"abstract":"<div><h3>Objectives</h3><div>Adolescents experience poor sexual and reproductive health outcomes, yet existing education and health services are insufficient. This study aims to improve adolescent sexual health knowledge and outcomes by co-creating service improvements with adolescent mothers based on their experiences from pre-pregnancy through parenting.</div></div><div><h3>Methods</h3><div>Using human-centered design, 16 adolescent mothers in New York City participated in 47 interviews to identify problems in adolescent sexual and reproductive health services and education. In two co-creation workshops, participants (n=10) designed solution prototypes, with a specific focus on improving contraceptive counseling. Healthcare stakeholders (n=10) informed prototype refinement.</div></div><div><h3>Results</h3><div>Participants highlighted deficiencies in sexual health education and emphasized the roles of healthcare providers and parents, rather than schools, in improving it. Adolescent participants designed messaging to support quality conversations between adolescents, parents, and providers and created a pre-appointment checklist to help young patients initiate conversations with providers. Young participants stressed that the toolkits address topics beyond STIs and pregnancy, like emotional health and relationships. They created guidelines for healthcare providers outlining communication strategies to provide respectful, unbiased care and contraceptive counseling that encourages adolescent autonomy. Participants shared specific suggestions for how to respectfully support young parents. Healthcare stakeholders recommended adding information on confidential care and supporting LGBTQ youth and suggested dissemination techniques. Prototypes were revised based on feedback.</div></div><div><h3>Conclusions</h3><div>This study highlighted the important roles that parents and healthcare workers play in adolescent sexual health education. Co-created toolkits offer a practical approach for providers, adolescents, and parents to have adolescent-centered conversations that promote adolescent autonomy, safety, and well-being.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426898","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":"Society of Family Planning Clinical Recommendation: Induction of fetal asystole before abortion Jointly developed with the Society for Maternal-Fetal Medicine","authors":"Justin Diedrich, Caroline N. Goldfarb, Shandhini Raidoo, Eleanor Drey, Matthew F. Reeves, with the assistance of Jessica Atrio Vinita Goyal and Sarah Prager on behalf of the Clinical Affiars Committee and Lorie Harper on behalf of the Society for Maternal-Fetal Medicine","doi":"10.1016/j.contraception.2024.110551","DOIUrl":"https://doi.org/10.1016/j.contraception.2024.110551","url":null,"abstract":"This document serves as a revision to the Society of Family Planning's 2010 guidelines, integrating literature on new techniques and research and addressing the clinical, medical, and sociolegal questions surrounding the induction of fetal asystole. Insufficient evidence exists to recommend routine induction of fetal asystole before previable medication and procedural abortion. However, at periviable gestations and after fetal viability, inducing fetal asystole before abortion prevents the infrequent but serious occurrence of unanticipated expulsion of a fetus with cardiorespiratory activity (Best Practice). Defining viability is complicated as it represents a physiological continuum impacted by gestational duration along with multiple other individual clinical factors and circumstances; therefore, the exact gestational duration to offer fetal asystole will depend on the setting and clinical circumstances. If induction of fetal asystole before abortion is available, we recommend engaging in patient-centered counseling regarding the risks and benefits of induction of fetal asystole in the setting of each unique pregnancy scenario and the patient's beliefs and priorities (Best Practice). We recommend that clinicians identify the optimal pharmacologic agent to administer for a given clinical scenario based on factors such as availability of each agent; the time frame in which fetal asystole needs to be established; and clinicians' technical ability, preferences, and practice (Best Practice). Potassium chloride, lidocaine, and digoxin are all acceptable pharmaceutical agents to induce fetal asystole before abortion. To establish asystole rapidly, we suggest the use of potassium chloride (via intracardiac or intrafunic injection) or lidocaine (via intracardiac or intrafunic injection) (GRADE 2C), although intrathoracic administration of lidocaine may be acceptable. We recommend potassium chloride not be used if intracardiac or intrafunic location cannot be achieved to avoid the risk of accidental administration to the pregnant individual and because insufficient data support its efficacy via other intrafetal locations (GRADE 1C). When using digoxin, we recommend intrafetal administration (GRADE 1C), although intraamniotic administration may be acceptable depending on a clinician's technical ability and setting. Because digoxin may take several hours to induce asystole, an alternative agent should be considered in settings where fetal asystole must be confirmed rapidly.","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259503","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(24)00384-6","DOIUrl":"10.1016/S0010-7824(24)00384-6","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010782424003846/pdfft?md5=ff20936e536f0a43f31b8986b232e13c&pid=1-s2.0-S0010782424003846-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(24)00236-1","DOIUrl":"10.1016/S0010-7824(24)00236-1","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0010782424002361/pdfft?md5=78e99135be95956bcbaa9b924eea1bf8&pid=1-s2.0-S0010782424002361-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Research Practice Support: Strategies and considerations for addressing race and racism in quantitative family planning studies","authors":"","doi":"10.1016/j.contraception.2024.110534","DOIUrl":"10.1016/j.contraception.2024.110534","url":null,"abstract":"<div><h3>Objectives</h3><div>Family planning researchers have not critically engaged with topics of race, racism, and associated concepts like ethnicity. This lack of engagement contributes to the reproduction of research that reifies racial hierarchies rather than illuminate and interrupt the processes by which racism affects health. This Research Practice Support paper lays out considerations and best practices for addressing race and racism in quantitative family planning research.</div></div><div><h3>Study design</h3><div>We are scholars with racialized identities and expertise in racial health equity in family planning research. We draw from scholarship and guidance across disciplines to examine common shortcomings in the use and analysis of race and racism and propose practices for rigorous use of these concepts in quantitative family planning research.</div></div><div><h3>Results</h3><div>We recommend articulating the role of race and racism in the development of the research question, authorship and positionality, study design, data collection, analytic approach, and interpretation of analyses. Definitions of relevant concepts and additional resources are provided.</div></div><div><h3>Conclusions</h3><div>Family planning and racism are inextricably linked. Failing to name and analyze the pathways through which structural racism affects family planning, and the people who need or want to plan if, when, or how to become pregnant or parent may reproduce harmful and incorrect beliefs about the causes of health inequities and the attributes of Black, Indigenous, and other people racialized as non-White. Family planning researchers should critically study racism and race with procedures grounded in appropriate and articulated theory, evidence, and analytic approaches.</div></div><div><h3>Implications</h3><div>Family planning research can better contribute to efforts to eliminate racialized health inequities and avoid perpetuating harmful beliefs and conceptualizations of race by ensuring that they study race and racism with procedures grounded in appropriate and articulated theory, evidence, and analytic approaches.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536176","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(24)00204-X","DOIUrl":"https://doi.org/10.1016/S0010-7824(24)00204-X","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S001078242400204X/pdfft?md5=e3d5444a933701ae2a17671cb1067574&pid=1-s2.0-S001078242400204X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ongoing contraceptive goals of patients who did not achieve desired postpartum permanent contraception prior to hospital discharge","authors":"","doi":"10.1016/j.contraception.2024.110533","DOIUrl":"10.1016/j.contraception.2024.110533","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate reasons for non-fulfillment and ongoing contraceptive plans of patients who desired but did not receive inpatient postpartum permanent contraception (PC).</div></div><div><h3>Study design</h3><div>Multi-site retrospective cohort study of 1254 patients with unfulfilled inpatient postpartum PC. We analyzed the reason for PC non-fulfillment, documented contraceptive plan, and method prescription or provision at hospital discharge, six-weeks, and one-year postpartum.</div></div><div><h3>Results</h3><div>In our cohort, 44.3% of patients with unfulfilled inpatient PC did not receive any highly- or moderately-effective contraception within one year postpartum.</div></div><div><h3>Conclusions</h3><div>Removing barriers to PC fulfillment as well as contraceptive counseling that acknowledges these barriers is imperative.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473644","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}