将长效可逆避孕干预措施映射到社会生态模型:范围界定综述。

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ghasi Phillips-Bell ScD, MS , Maria Roque MPH , Lisa Romero DrPH, MPH
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引用次数: 0

摘要

引言:长效可逆避孕(LARC)是预防意外怀孕和短间隔妊娠的一种选择。增加避孕机会的努力可能受益于应用社会生态模型,该模型考虑了个人、人际、组织、社区和政策对行为的影响。我们旨在总结LARC使用干预措施的结果,并将干预措施映射到SEM水平。方法:我们对PubMed/MEDLINE和Embase数据库中2010-2020年的文献进行了范围界定审查,以总结是否增加LARC使用的干预措施。尽管从生殖自主的角度来看,增加LARC的使用不是一个合适的目标,但这是迄今为止进行的许多研究的既定目标,通常表明获得LARC的机会有所改善。我们将这些干预措施映射到SEM水平,并对其策略进行分类:成本支持、患者咨询、行政支持、提供者培训和其他。结果:在审查的27项干预措施中,17项(63%)增加了LARC的使用。我们观察到,与在其他SEM级别实施的干预措施相比,在那些在政策(8/10[80%])或组织(14/19[74%])SEM级别实施策略的人中,增加LARC吸收的干预措施比例更大。当同时实施个人和组织SEM层面的组成部分时,六项干预措施中的五项(83%)提高了吸收率。所有五项同时包含组织和政策层面的干预措施都增加了LARC的使用。在27项干预措施中,患者咨询(n=12)和费用支持(n=12个)是常见的策略。12项干预措施中有5项(42%)涉及患者咨询,12项干预中有11项(92%)涉及成本支持,增加了LARC的使用。结论:组织和政策SEM组成部分和成本支持策略在增加LARC使用的干预措施中最为普遍。在尊重患者自主性的同时,未来改善避孕机会的干预措施可以包括不止一个SEM级别。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mapping Long-acting Reversible Contraceptive Interventions to the Social Ecological Model: A Scoping Review

Introduction

Long-acting reversible contraception (LARC) is one option for preventing unintended pregnancies and short interpregnancy intervals. Efforts to increase access to contraception may benefit from applying the social ecological model (SEM), a framework that considers individual, interpersonal, organizational, community, and policy influences on behavior. We aimed to summarize findings from interventions on LARC use and map interventions to SEM levels.

Methods

We conducted a scoping review of the 2010–2020 literature in PubMed/MEDLINE and Embase databases to summarize interventions that did and did not increase LARC use. Although increasing LARC use is not an appropriate goal from a reproductive autonomy standpoint, it is the stated goal of much of the research conducted to date and typically indicates an improvement in access. We mapped these interventions to SEM levels and categorized their strategies: cost support, patient counseling, administrative support, provider training, and other.

Results

Of 27 interventions reviewed, 17 (63%) increased LARC use. We observed a greater proportion of interventions that increased LARC uptake among those with strategies implemented at policy (8/10 [80%]) or organizational (14/19 [74%]) SEM levels compared with interventions implemented at other SEM levels. When both individual and organizational SEM-level components were implemented, five of six interventions (83%) increased uptake. All five interventions with both organizational- and policy-level components increased LARC use. Among the 27 interventions, patient counseling (n = 12) and cost support (n = 12) were common strategies. Five of 12 interventions (42%) involving patient counseling and 11 of 12 (92%) involving cost support increased LARC use.

Conclusions

Organizational and policy SEM components and cost support strategies were most prevalent in interventions that increased LARC use. Future interventions to improve access to contraception, while respecting patient autonomy, could incorporate more than one SEM level.

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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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