Expanding Contraception Access for Women With Opioid-Use Disorder: A Qualitative Study of Opportunities and Challenges.
Expanding Contraception Access for Women With Opioid-Use Disorder: A Qualitative Study of Opportunities and Challenges.
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DOI：
10.1177/0890117120927327
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Miller MK
中科院分区：
文献类型：
--
作者：
Hurley EA;Duello A;Finocchario-Kessler S;Goggin K;Stancil S;Winograd RP;Miller MK
由于阿片类药物使用障碍（OUD）妇女中近十分之九的怀孕是意外的，因此扩大避孕药具的获得是一项未得到充分利用但可能有效的战略，可以增加生殖机构并减少新生儿禁欲综合征的总体负担。我们的目的是确定在哪里以及如何将避孕服务纳入现有的接触点，为妇女与OUD。深入的定性访谈。密苏里州的三个不同的集水区。OUD妇女（n = 15）和专业利益相关者（n = 16）代表五种类型的现有OUD服务点：注射器交换计划，恢复支持计划，物质使用治疗计划，急诊室和联邦合格的卫生中心。访谈录音，转录，并使用Dedoose软件的主题编码。将避孕服务纳入现有的接触点的六个主题出现的基本组成部分：（1）接触妇女未满足的需求;（2）提供免费或负担得起的避孕;（3）最大限度地提供服务;（4）提供以病人为中心的护理;（5）雇用愿意，合格的避孕提供者;和（6）利用同伴教育。与会者肯定了避孕服务一体化的总体潜在效益，并说明了与每类现有服务点有关的各种机会和挑战。由于健康促进倡议希望增加患有开放式吸毒妇女获得避孕药具的机会，参与者确定的这六个组成部分为选择有利的接触点和解决服务中的剩余差距提供了必要的指导。
As almost nine in ten pregnancies among women with opioid use disorder (OUD) are unintended, expanding access to contraception is an underutilized but potentially effective strategy in increasing reproductive agency and reducing the overall burden of neonatal abstinence syndrome. We aimed to identify where and how contraceptive services could be integrated into existing points-of-contact for women with OUD. In-depth qualitative interviews. Three diverse catchment areas in Missouri. Women with OUD (n = 15) and professional stakeholders (n = 16) representing five types of existing OUD service points: syringe exchange programs, recovery support programs, substance use treatment programs, emergency departments, and Federally Qualified Health Centers. Interviews were audio-recorded, transcribed, and thematically coded using Dedoose software. Six themes emerged as essential components for integrating contraceptive services into existing points-of-contact for women with OUD: (1) reach women with unmet need; (2) provide free or affordable contraception; (3) maximize service accessibility; (4) provide patient-centered care; (5) employ willing, qualified contraceptive providers; and (6) utilize peer educators. Participants affirmed the overall potential benefit of contraceptive service integration and illuminated various opportunities and challenges relevant to each type of existing service point. As health promotion initiatives look to increase access to contraception among women with OUD, these six’ participant-identified components offer essential guidance in selecting advantageous points-of-contact and addressing remaining gaps in services.
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