Beyond same-day long-acting reversible contraceptive access: a person-centered framework for advancing high-quality, equitable contraceptive care - 02/04/20
, Reiley Reed, MPH a, Joia Crear-Perry, MD d, Cherisse Scott e, Sarah Wulf, MPH a, Christine Dehlendorf, MD a, b, cAbstract |
In the last decade-plus, there has been growing enthusiasm for long-acting reversible contraceptive methods as the solution to unintended pregnancy in the United States. Contraceptive access efforts have primarily focused on addressing provider and policy barriers to long-acting reversible contraception and have promoted long-acting reversible contraception as first-line methods through marketing and tiered-effectiveness counseling. A next generation of contraceptive access efforts has the opportunity to move beyond this siloed focus on long-acting reversible contraception toward a focus on equity and person-centeredness. Here we define a new framework for increasing equitable access to high-quality, person-centered contraceptive care that includes programmatic elements necessary to provide information and services to address the barriers to accessing quality care, organized into a four-part continuum. The continuum is contextualized within structural, systematic, and social factors that influence experience of contraceptive care. We aim to provide a practical framework for researchers, program implementers, and policy makers to develop and evaluate efforts to improve equitable access to and quality of contraceptive care. Initiatives can intentionally be cognizant of broader structural and social factors that will influence their success and the likelihood of negative unintended consequences for marginalized groups and thus deliberately work to design programs that meet all people’s contraceptive needs and support reproductive autonomy.
Le texte complet de cet article est disponible en PDF.Key words : contraceptive access, contraceptive counseling, health equity, long-acting, reversible contraception, patient-centered care, reproductive autonomy, shared decision making
| This study was supported by funds from the David and Lucile Packard Foundation. The Packard Foundation played no role in the development of the framework presented in this Call to Action. |
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| The authors report no conflict of interest. |
Vol 222 - N° 4S
P. S878.e1-S878.e6 - avril 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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