Dispersion of contraceptive access policies across the United States from 2006 to 2021.
Dispersion of contraceptive access policies across the United States from 2006 to 2021.
复制标题
DOI：
10.1016/j.pmedr.2022.101827
复制
发表时间：
2022-06
影响因子：
2.8
通讯作者：
Hall, Kelli Stidham
中科院分区：
文献类型：
--
作者：
Rice, Whitney S.;Redd, Sara K.;Luke, Alina A.;Komro, Kelli;Arriola, Kimberly Jacob;Hall, Kelli Stidham
我们监测并呈现各州和各时期避孕政策的模式。各州普遍增加了高级执业注册护士的执业权限。在研究期间，医疗补助扩张政策也很常见。西部和东北部地区制定了更广泛的避孕政策。我们提供了按州和年份分列的避孕药具获取政策数据，供未来研究使用。以人为中心的避孕药具获得有利于生殖自主，性健康，月经调节和其他预防性健康。然而，避孕药具的获得情况因社会和地理位置而异，政策要么使保健不平等现象持续下去，要么减轻这种不平等现象。我们描述了从2006年到2021年，美国50个州和华盛顿，华盛顿特区（统称为州）的州一级避孕药具获取政策从少（不太广泛）到多（更广泛）的指数的地理和时间趋势变化。我们从主要和次要来源收集了23项政策的数据，这些政策涉及避孕教育、保险覆盖范围、未成年人权利、提供者权力等。截至2021年，颁布最多的政策通过以下方式扩大了避孕药具的获得：1）护士执业者、注册护士助产士的处方权（n = 50，98%的州）和临床护理专家（n = 38，75%）; 2）医疗补助扩大（n = 38，75%）; 3）处方方法保险范围（n = 30，59%）;和4）执业护士和注册护士助产士的配药权（n = 29，57%）。美国整体政策指数的平均值从2006年的6.9上升到2021年的8.6。西部和东北部地区的州拥有最广泛的避孕药具获取景观（平均指数值分别为9.0和8.2），并且随着时间的推移变得更加广泛（增加了4-5项政策）。中西部和南部的景观最不广阔（平均指数值分别为5.0和6.1）。性健康和生殖健康政策环境较为宽松的地区进一步扩大了获得服务的机会，而最不宽松的环境则得以维持。需要更细致地了解避孕政策的传播如何影响健康结果和公平，以告知公共卫生宣传和立法。
We surveil and present patterns in contraceptive policies across states and time. States commonly increased Advanced Practice Registered Nurses’ practice authority. Medicaid expansion policies were also common during the study period. More expansive contraceptive policies were enacted in West and Northeast regions. We provide contraceptive access policy data by state and year for future research. Person-centered contraceptive access benefits reproductive autonomy, sexual wellbeing, menstrual regulation, and other preventive health. However, contraceptive access varies by social and geographic position, with policies either perpetuating or alleviating health inequities. We describe geographic and time-trend variation in an index from fewer (less expansive) to greater (more expansive) aggregation of U.S. state-level contraceptive access policies across 50 states and Washington, D.C. (collectively, states) from 2006 to 2021. We collected data from primary and secondary sources on 23 policies regulating contraceptive education, insurance coverage, minor’s rights, provider authority, and more. As of 2021, the most enacted policies expanded contraceptive access through: 1) prescribing authority for nurse practitioners, certified nurse-midwives (n = 50, 98 % of states), and clinical nurse specialists (n = 38, 75 %); 2) Medicaid expansion (n = 38, 75 %); 3) prescription method insurance coverage (n = 30, 59 %); and 4) dispensing authority for nurse practitioners and certified nurse-midwives (n = 29, 57 %). The average overall U.S. policy index value increased in expansiveness from 6.9 in 2006 to 8.6 in 2021. States in the West and Northeast regions had the most expansive contraceptive access landscapes (average index values of 9.0 and 8.2, respectively) and grew more expansive over time (increased by 4–5 policies). The Midwest and South had least expansive landscapes (average index values of 5.0 and 6.1, respectively). Regions with more expansive sexual and reproductive health policy environments further expanded access, whereas least expansive environments were maintained. More nuanced understanding of how contraceptive policy diffusion affects health outcomes and equity is needed to inform public health advocacy and law making.
登录
查看更多内容
影响因子：
1.1
作者：
Branscum, Caralin;Fallik, Seth Wyatt
通讯作者：
Fallik, Seth Wyatt
影响因子：
3.6
作者：
Higgins JA;Kramer RD;Wright KQ;Everett B;Turok DK;Sanders JN
通讯作者：
Sanders JN
影响因子：
2.9
作者：
Canestaro, W.;Vodicka, E.;Trussell, J.
通讯作者：
Trussell, J.
影响因子：
2.2
作者：
Garg, Namrata;Volerman, Anna
通讯作者：
Volerman, Anna
影响因子：
2.4
作者：
Dodson, Elizabeth A.;Geary, Nora A.;Brownson, Ross C.
通讯作者：
Brownson, Ross C.