Evaluating a Longitudinal Cohort of Clinics Engaging in the Family Planning Elevated Contraceptive Access Program: Study Protocol for a Comparative Interrupted Time Series Analysis.
Evaluating a Longitudinal Cohort of Clinics Engaging in the Family Planning Elevated Contraceptive Access Program: Study Protocol for a Comparative Interrupted Time Series Analysis.
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DOI：
10.2196/18308
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发表时间：
2020-10-16
影响因子：
1.7
通讯作者：
Turok DK
中科院分区：
文献类型：
--
作者：
Simmons RG;Myers K;Gero A;Sanders JN;Quade C;Mullholand M;Turok DK
获得高质量、全面的避孕护理是生殖人权的固有组成部分。然而，在避孕提供的具体方面，包括可获得性、可及性、可接受性和质量等方面存在的障碍，继续导致需求得不到满足。犹他州最近通过了一系列避孕政策，旨在改善避孕措施的获取途径。尽管在理论上获取途径有了这些积极变化，但用于支持这些政策实施的财政拨款却很少，许多人仍然难以获得避孕措施。
计划生育提升避孕获取途径项目（FPE CAP）是一项更大的全州避孕倡议的一部分，其具体目标是改善医疗诊所内避孕措施的获取情况。本文介绍了评估FPE CAP成功与否的研究方案。
医疗诊所申请加入FPE CAP。一旦被该项目接受，它们将获得用于临床用品、设备和人员费用的现金补助；为符合条件的客户报销避孕服务和避孕方法的费用；在咨询和提供所有避孕方法方面提供技术支持、培训和指导；储备宫内节育器和植入物等避孕方法；以及开展需求激发活动，包括当地媒体宣传活动，以便向社区成员介绍FPE CAP以及可能的资格条件。FPE从参与的诊所收集每月的服务提供报告用于评估目的。FPE CAP的主要成果是，在加入FPE CAP之后，收入≤联邦贫困线138%的个人以及收入在联邦贫困线139% - 250%之间的FPE CAP客户（包括那些没有资格享受医疗补助的人）避孕服务提供的水平和趋势变化，并与历史数据和对照诊所进行比较。为了评估这一点，我们将进行比较性中断时间序列分析，评估干预前12个月、干预持续的2年期间以及干预后随后的12个月内干预诊所和对照诊所的水平和趋势变化。
我们发现，按照我们计划的诊所数量以及研究中可用的数据月数，该研究具有足够的效力（效力>80%）。到目前为止，我们已经成功完成了预期的9个卫生组织中的8个以及4个对照诊所的招募和登记。预计干预组织和对照组织的卫生组织登记工作将于2020年12月全部完成。
该研究旨在通过在卫生系统层面解决避孕护理的各个方面，为避孕倡议的新方法提供见解。正在进行的州政策变化和实施内容可能会影响评估结果。
DERR1 - 10.2196/18308
Access to high-quality, comprehensive contraceptive care is an inherent component of reproductive human rights. However, hindrances to specific aspects of contraceptive provision, including availability, accessibility, acceptability, and quality, continue to perpetuate unmet needs. The state of Utah has recently passed a series of contraceptive policies intended to improve contraceptive access. Despite these positive changes to theoretical access, fiscal appropriations to support the implementation of these policies have been minimal, and many individuals still struggle to access contraception. The Family Planning Elevated Contraceptive Access Program (FPE CAP), part of a larger statewide contraceptive initiative, specifically aims to improve contraceptive access within health clinics. This paper describes the study protocol for evaluating the success of FPE CAP. Health clinics apply for membership in the FPE CAP. On acceptance in the program, they receive a cash grant for clinical supplies, equipment, and personnel expenses; reimbursement for contraceptive services and methods for eligible clients; technical support, training, and proctoring on counseling and providing all methods of contraception; method stocking of intrauterine devices and implants; and demand generation activities, including local media campaigns, to inform community members about the FPE CAP and possible eligibility. FPE collects monthly service delivery reports from participating clinics for evaluation purposes. The primary outcomes of FPE CAP are level and trend changes in contraceptive service delivery among individuals earning ≤138% federal poverty level (FPL) following membership in FPE CAP and among FPE CAP clients earning between 139% and 250% FPL (including those ineligible for Medicaid) compared with historical data and control clinics. To assess this, we will conduct comparative interrupted time series analyses assessing the level and trend changes in intervention and control clinics 12 months before the intervention, for the 2-year duration of the intervention, and for the subsequent 12 months following the intervention. We found that the study is adequately powered (>80% power) with our planned number of clinics and the number of months of data available in the study. To date, we have successfully completed the recruitment and enrollment of 8 of the expected 9 health organizations and 4 of the control clinics. Completed health organization enrollment for both intervention and control organizations is expected to be completed in December 2020. The study aims to provide insight into a new approach to contraceptive initiatives by addressing comprehensive aspects of contraceptive care at the health system level. Ongoing state policy changes and implementation components may affect the evaluation outcomes. DERR1-10.2196/18308