Christine Tucker, Alison B Singer, Olivia E Horton, Lindsey Yates, Dorothy Cilenti, Jeremy Moulton
{"title":"通过增加获得长效可逆避孕措施来改善生育结果：北卡罗来纳州一个国家资助项目的影响分析。","authors":"Christine Tucker, Alison B Singer, Olivia E Horton, Lindsey Yates, Dorothy Cilenti, Jeremy Moulton","doi":"10.1097/PHH.0000000000002334","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between a state-funded program in North Carolina (NC) to increase access to long-acting reversible contraception (LARC) through local health departments and to reduce preterm birth (PTB) and low birthweight (LBW).</p><p><strong>Design: </strong>This population-based cohort study used a difference-in-differences approach to determine if PTB and LBW in the postintervention period (2018-2019) differed from the preintervention period (2013-2015) comparing treatment to comparator counties.</p><p><strong>Setting and intervention: </strong>Improving Community Outcomes for Maternal and Child Health funding began in June 2016 in 13 counties to improve access to LARC.</p><p><strong>Outcome measures: </strong>PTB and LBW data came from the NC Consolidated Linked Birth File, live birth certificate data probabilistically linked with other public health sources.</p><p><strong>Results: </strong>Our sample included 150 045 births from 13 treatment counties grouped into three treatment groups and 249 173 births from 56 comparator counties. There was no statistically significant decrease in PTB, and a 0.4 percentage point decrease in LBW (95% CI, -0.7, -0.1) comparing all ICO4MCH counties to comparators. We observed a one-percentage point decrease in PTB in two of the three ICO4MCH groups compared to comparator counties [Durham: -1.0 (95% CI, -1.7, -0.2) and High Country-Robeson-Sandhills: -0.9 (95% CI, -1.5, -0.4)]. For LBW, in the more rural treatment counties, there was a 1.2 percentage point difference (95% CI, -1.7, -0.8) in average predicted prevalence comparing the post- to preintervention period compared to the comparator counties. There was a statistically significant reduction in LBW for White and Black mothers in the more rural treatment counties compared to counterparts in comparator counties.</p><p><strong>Conclusions: </strong>Findings from this evaluation showed a small reduction in PTB and LBW at the population level, particularly in rural counties and among Black or African American women residing in rural counties.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"303-312"},"PeriodicalIF":1.9000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improving Birth Outcomes Through Increasing Access to Long-acting Reversible Contraception: An Impact Analysis of a State-funded Program in North Carolina.\",\"authors\":\"Christine Tucker, Alison B Singer, Olivia E Horton, Lindsey Yates, Dorothy Cilenti, Jeremy Moulton\",\"doi\":\"10.1097/PHH.0000000000002334\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To examine the association between a state-funded program in North Carolina (NC) to increase access to long-acting reversible contraception (LARC) through local health departments and to reduce preterm birth (PTB) and low birthweight (LBW).</p><p><strong>Design: </strong>This population-based cohort study used a difference-in-differences approach to determine if PTB and LBW in the postintervention period (2018-2019) differed from the preintervention period (2013-2015) comparing treatment to comparator counties.</p><p><strong>Setting and intervention: </strong>Improving Community Outcomes for Maternal and Child Health funding began in June 2016 in 13 counties to improve access to LARC.</p><p><strong>Outcome measures: </strong>PTB and LBW data came from the NC Consolidated Linked Birth File, live birth certificate data probabilistically linked with other public health sources.</p><p><strong>Results: </strong>Our sample included 150 045 births from 13 treatment counties grouped into three treatment groups and 249 173 births from 56 comparator counties. There was no statistically significant decrease in PTB, and a 0.4 percentage point decrease in LBW (95% CI, -0.7, -0.1) comparing all ICO4MCH counties to comparators. We observed a one-percentage point decrease in PTB in two of the three ICO4MCH groups compared to comparator counties [Durham: -1.0 (95% CI, -1.7, -0.2) and High Country-Robeson-Sandhills: -0.9 (95% CI, -1.5, -0.4)]. For LBW, in the more rural treatment counties, there was a 1.2 percentage point difference (95% CI, -1.7, -0.8) in average predicted prevalence comparing the post- to preintervention period compared to the comparator counties. There was a statistically significant reduction in LBW for White and Black mothers in the more rural treatment counties compared to counterparts in comparator counties.</p><p><strong>Conclusions: </strong>Findings from this evaluation showed a small reduction in PTB and LBW at the population level, particularly in rural counties and among Black or African American women residing in rural counties.</p>\",\"PeriodicalId\":47855,\"journal\":{\"name\":\"Journal of Public Health Management and Practice\",\"volume\":\" \",\"pages\":\"303-312\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2026-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Public Health Management and Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PHH.0000000000002334\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2026/2/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Public Health Management and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PHH.0000000000002334","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Improving Birth Outcomes Through Increasing Access to Long-acting Reversible Contraception: An Impact Analysis of a State-funded Program in North Carolina.
Objective: To examine the association between a state-funded program in North Carolina (NC) to increase access to long-acting reversible contraception (LARC) through local health departments and to reduce preterm birth (PTB) and low birthweight (LBW).
Design: This population-based cohort study used a difference-in-differences approach to determine if PTB and LBW in the postintervention period (2018-2019) differed from the preintervention period (2013-2015) comparing treatment to comparator counties.
Setting and intervention: Improving Community Outcomes for Maternal and Child Health funding began in June 2016 in 13 counties to improve access to LARC.
Outcome measures: PTB and LBW data came from the NC Consolidated Linked Birth File, live birth certificate data probabilistically linked with other public health sources.
Results: Our sample included 150 045 births from 13 treatment counties grouped into three treatment groups and 249 173 births from 56 comparator counties. There was no statistically significant decrease in PTB, and a 0.4 percentage point decrease in LBW (95% CI, -0.7, -0.1) comparing all ICO4MCH counties to comparators. We observed a one-percentage point decrease in PTB in two of the three ICO4MCH groups compared to comparator counties [Durham: -1.0 (95% CI, -1.7, -0.2) and High Country-Robeson-Sandhills: -0.9 (95% CI, -1.5, -0.4)]. For LBW, in the more rural treatment counties, there was a 1.2 percentage point difference (95% CI, -1.7, -0.8) in average predicted prevalence comparing the post- to preintervention period compared to the comparator counties. There was a statistically significant reduction in LBW for White and Black mothers in the more rural treatment counties compared to counterparts in comparator counties.
Conclusions: Findings from this evaluation showed a small reduction in PTB and LBW at the population level, particularly in rural counties and among Black or African American women residing in rural counties.
期刊介绍：
Journal of Public Health Management and Practice publishes articles which focus on evidence based public health practice and research. The journal is a bi-monthly peer-reviewed publication guided by a multidisciplinary editorial board of administrators, practitioners and scientists. Journal of Public Health Management and Practice publishes in a wide range of population health topics including research to practice; emergency preparedness; bioterrorism; infectious disease surveillance; environmental health; community health assessment, chronic disease prevention and health promotion, and academic-practice linkages.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
