Factors Associated With Knowledge and Experience of Self-managed Abortion Among Patients Seeking Care at 49 US Abortion Clinics.
Factors Associated With Knowledge and Experience of Self-managed Abortion Among Patients Seeking Care at 49 US Abortion Clinics.
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DOI：
10.1001/jamanetworkopen.2023.8701
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发表时间：
2023-04-03
影响因子：
13.8
通讯作者：
Scott, James G.
中科院分区：
文献类型：
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作者：
Aiken, Abigail R. A.;Tello-Perez, Luisa Alejandra;Madera, Melissa;Starling, Jennifer E.;Johnson, Dana M.;Broussard, Kathleen;Padron, Elisa;Ze-Noah, Carol Armelle;Baldwin, Aleta;Scott, James G.
这项调查研究评估了在美国29个州的49家堕胎诊所寻求护理的患者中与自我管理堕胎的知识和经验相关的因素。寻求堕胎的美国患者在去诊所之前考虑或尝试自我管理堕胎的频率有多高，哪些因素与自我管理行为相关？在这项对29个州49家堕胎诊所的19830名患者进行的调查研究中，八分之一的患者在去诊所之前考虑过自我管理，其中三分之一的患者试图这样做。个人层面的因素，包括经历诊所访问障碍和更喜欢在家里照顾，与自我管理行为。这些研究结果表明，考虑自我管理堕胎是在诊所获得护理的一个常见部分，那些在诊所获得服务的边缘或更喜欢在家护理的人更有可能自我管理。在美国堕胎诊所就诊的患者可能会在来诊所之前考虑或尝试自我管理堕胎，但对与自我管理行为相关的因素知之甚少。检查在去诊所之前考虑或尝试自我管理堕胎的患病率和相关因素。这项调查研究包括在2018年12月至2020年5月期间在29个州选择的49个独立，计划生育和学术附属诊所进行堕胎的患者，以最大限度地提高地理，国家政策和人口背景的多样性。数据分析时间为2020年12月至2021年7月。在诊所堕胎。了解用于自我管理堕胎的药物，在去诊所之前考虑过药物自我管理，在去诊所之前考虑过任何自我管理的方法，在去诊所之前尝试过任何自我管理的方法。该研究纳入了19，830名患者，其中99.6% (17 823例患者）确定为女性; 60.9% 11834例患者年龄20~29岁，占29.6%，（5824例患者）确定为黑人，19.3%（3799例患者）为西班牙裔，36.0%（7095例患者）为非西班牙裔白色人; 44.1%（8252例）接受社会服务; 78.3%大约三分之一（34%）的人知道自我管理的药物流产，在6750名患者的子样本中，1/6例（1079例患者[16.1%]）在就诊前曾考虑使用药物进行自我管理。在全样本中，1/8（11.7%）的患者考虑在就诊前使用任何方法进行自我管理，在2328例患者的子样本中，几乎1/3（670例患者[28.8%]）的患者尝试这样做。对家庭流产护理的偏好与考虑药物自我管理（比值比[OR]，3.52; 95%CI，2.94 - 4.21）、考虑任何自我管理方法（OR，2.80; 95%CI，2.50 - 3.13）和尝试任何自我管理方法（OR，1.37; 95%CI，1.10 - 1.69）相关。经历诊所访问障碍也与考虑药物自我管理（OR，1.98; 95% CI，1.69 - 2.32）和考虑任何自我管理方法（OR，2.09; 95% CI，1.89 - 2.32）相关。在这项调查研究中，在获得诊所护理之前考虑自我管理堕胎是很常见的，特别是在那些处于边缘地位或倾向于家庭护理的人中。这些研究结果表明，需要扩大远程医疗和其他分散的堕胎护理模式。
This survey study evaluates the factors associated with knowledge and experience of self-managed abortion among patients seeking care at 49 US abortion clinics in 29 states. How commonly do US patients seeking an abortion consider or attempt self-managed abortion before attending a clinic, and what factors are associated with self-management behavior? In this survey study of 19 830 patients attending 49 abortion clinics in 29 states, 1 in 8 considered self-managing before attending the clinic, and of these, 1 in 3 attempted to do so. Individual-level factors, including experiencing clinic access barriers and preferring at-home care, were associated with self-management behavior. These findings suggest that considering self-managed abortion is a common part of the path to accessing care in a clinic, and those on the margins of clinic access or who prefer at-home care are more likely to self-manage. Patients attending US abortion clinics may consider or try self-managing their abortion before coming to the clinic, yet little is known about the factors associated with self-management behavior. To examine the prevalence and factors associated with considering or attempting a self-managed abortion before attending a clinic. This survey study included patients obtaining an abortion at 49 independent, Planned Parenthood, and academic-affiliated clinics chosen to maximize diversity in geographic, state policy, and demographic context in 29 states between December 2018 and May 2020. Data were analyzed from December 2020 to July 2021. Obtaining an abortion at a clinic. Knowledge of medications used to self-manage an abortion, having considered medication self-management before attending the clinic, having considered any method of self-management before attending the clinic, and having tried any method of self-management before attending the clinic. The study included 19 830 patients, of which 99.6.% (17 823 patients) identified as female; 60.9% (11 834 patients) were aged 20 to 29 years; 29.6% (5824 patients) identified as Black, 19.3% (3799 patients) as Hispanic, and 36.0% (7095 patients) as non-Hispanic White; 44.1% (8252 patients) received social services; and 78.3% (15 197 patients) were 10 weeks pregnant or less. Approximately 1 in 3 (34%) knew about self-managed medication abortion, and among this subsample of 6750 patients, 1 in 6 (1079 patients [16.1%]) had considered using medications to self-manage before attending the clinic. Among the full sample, 1 in 8 (11.7%) considered self-managing using any method before clinic attendance, and among this subsample of 2328 patients, almost 1 in 3 (670 patients [28.8%]) attempted to do so. Preference for at-home abortion care was associated with considering medication self-management (odds ratio [OR], 3.52; 95% CI, 2.94-4.21), considering any method of self-management (OR, 2.80; 95% CI, 2.50-3.13), and attempting any method of self-management (OR, 1.37; 95% CI, 1.10-1.69). Experiencing clinic access barriers was also associated with considering medication self-management (OR, 1.98; 95% CI, 1.69-2.32) and considering any method of self-management (OR, 2.09; 95% CI, 1.89-2.32). In this survey study, considering self-managed abortion was common before accessing in-clinic care, particularly among those on the margins of access or with a preference for at-home care. These findings suggest a need for expanded access to telemedicine and other decentralized abortion care models.
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影响因子：
7.2
作者：
Grossman D;Baba CF;Kaller S;Biggs MA;Raifman S;Gurazada T;Rafie S;Averbach S;Meckstroth KR;Micks EA;Berry E;Raine-Bennett TR;Creinin MD
通讯作者：
Creinin MD
影响因子：
9.8
作者：
Aiken, Abigail R. A.;Broussard, Kathleen;Scott, James G.
通讯作者：
Scott, James G.
影响因子：
13.8
作者：
Aiken ARA;Starling JE;Gomperts R
通讯作者：
Gomperts R
影响因子：
6.1
作者：
MUNDLAK, Y
通讯作者：
MUNDLAK, Y
DOI：
10.1016/j.ssmqr.2022.100075
发表时间：
2022-12-01
期刊：
SSM-QUALITATIVE RESEARCH IN HEALTH
影响因子：
--
作者：
Madera, Melissa;Johnson, Dana M.;Aiken, Abigail R. A.
通讯作者：
Aiken, Abigail R. A.