Contraceptive Method Uptake at Title X Health Centers in Utah.

Autor: Sexsmith CD; Division of Family Planning, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah., Sanders JN; Division of Family Planning, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah., Simmons RG; Division of Family Planning, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah., Dalessandro C; Division of Family Planning, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah. Electronic address: cristen.dalessandro@hsc.utah.edu., Turok DK; Division of Family Planning, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah.
Jazyk: angličtina
Zdroj: Women's health issues : official publication of the Jacobs Institute of Women's Health [Womens Health Issues] 2021 May-Jun; Vol. 31 (3), pp. 219-226. Date of Electronic Publication: 2021 Mar 06.
DOI: 10.1016/j.whi.2021.01.003
Abstrakt: Background: The Title X family planning program previously supported contraception for Utah clients with low incomes, yet its contributions may not have been sufficient to allow clients to select their preferred methods, including long-acting reversible contraceptives (LARCs). In this study, we compare the contraceptive method choices of self-paying clients with low incomes at three participating Title X health centers in Salt Lake County, Utah, before and after the removal of additional cost barriers.
Methods: We used retrospective medical record review to assess clients' contraceptive choices during two 6-month periods: a control period with Title X-assisted sliding scale payment schedules (n = 2,776) and an intervention period offering no-cost contraceptive care (n = 2,065). We used logistic regression to identify the likelihood of selecting a LARC during the intervention period and multinomial regression to identify the selection probability of different types of available LARCs.
Results: During the control period, 16% of participants chose a LARC compared with 26% in the intervention period (p ≤ .001). During the intervention period, participants were 1.8 times more likely to select LARCs (95% confidence interval, 1.65-2.13) compared with non-LARC methods, holding covariates constant. In the multinomial regression, participants were three times more likely during the intervention period to select an implant than a pill, patch, or ring, holding all other covariates constant (odds ratio, 3.08; 95% confidence interval, 2.47-3.83).
Conclusions: Title X clients offered contraceptive methods without cost more frequently selected a LARC method. Title X funding reductions may impede individuals' access to their contraceptive methods of choice.
(Copyright © 2021 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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