员工对在初级保健机构提供药物流产的态度

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2025-10-13 DOI:10.1016/j.contraception.2025.111078

S Srinivasulu, MG Manze, HE Jones

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引用次数: 0

摘要

目的评估10家参与药物流产项目的初级保健诊所工作人员对提供药物流产的基本态度。方法在2024年，来自8个州10个组织的员工冠军对准备引入药物流产的诊所工作人员进行了在线调查（n=908）。资格标准包括可能直接或间接参与药物流产就诊的非冠军工作人员。调查询问了与药物流产的可接受性和在初级保健中的归属、在提供药物流产的诊所工作的舒适性以及关于益处和关注点的开放式问题有关的观点。我们根据共同的主题组织了开放式的回答。我们使用聚类稳健标准误差进行回归分析，探讨与药物流产态度相关的员工特征。结果回复721例（79.4%）；454人符合资格标准。约387人（85.2%）认为应在初级保健中提供药物流产；只有75人（16.5%）觉得在提供这种服务的诊所工作不舒服。各组织之间在所有结果上存在显著差异（p<0.04）。在我们控制了组织内的聚类后，学术和社区卫生中心的参与者对药物流产实施的接受度得分显著高于联邦合格卫生中心的参与者（p<0.01）；在非lgbtq诊所工作的人的比例更低（p<0.001）；面向患者的临床工作人员比服务人员更低（p < 0.01）。感知到的好处包括减轻获取障碍（50.5%），与初级保健价值观保持一致（36.8%），促进生殖自主（10.6%）。关注的问题包括安全风险（34.2%）、培训（28.2%）和员工反对（17.6%）。31.3%的人明确表示不担心。结论这些初级保健诊所的大多数工作人员都支持提供药物流产，但在实施过程中有一些问题需要解决。

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STAFF ATTITUDES TOWARD PROVIDING MEDICATION ABORTION IN PRIMARY CARE SETTINGS

Objectives

We assessed baseline staff attitudes toward providing medication abortion in 10 primary care clinics participating in a program to adopt medication abortion.

Methods

In 2024, staff champions from 10 organizations in eight states administered our online survey to staff at clinics preparing to introduce medication abortion (n=908). Eligibility criteria included non-champion staff who could directly or indirectly be involved in a medication abortion visit. Surveys queried on perspectives related to medication abortion acceptability and belonging in primary care, comfort working in a clinic providing it, and open-ended questions on benefits and concerns. We organized open-ended responses into common themes. We conducted regression analysis using cluster-robust standard errors to explore staff characteristics associated with medication abortion attitudes.

Results

Some 721 responded (79.4%); 454 met eligibility criteria. Some 387 (85.2%) believed medication abortion should be available in primary care; only 75 (16.5%) felt uncomfortable working in a clinic that provides it. Significant differences between organizations exist across all outcomes (p<0.04). After we controlled for clustering within organizations, acceptability of medication abortion implementation scores were significantly higher among participants at academic and community health centers than at federally qualified health centers (p<0.01); lower among those working in non-LGBTQ-specific clinics (p<0.001); and lower among patient-facing clinic staff than among providers (p<0.01). Perceived benefits included mitigating access barriers (50.5%), aligning with primary care values (36.8%), and promoting reproductive autonomy (10.6%). Concerns included safety risks (34.2%), training (28.2%), and staff opposition (17.6%). Some 31.3% explicitly stated no concerns.

Conclusions

Most staff at these primary care clinics are supportive of providing medication abortion, but have concerns that champions should address during implementation.

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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.