Cheryl L Robbins1, Loretta Gavin2, Marion W Carter3, Susan B Moskosky4. 1. Epidemiologist, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, The Centers for Disease Control and Prevention, Atlanta. 2. Senior health scientist, Office of Population Affairs, U.S. Department of Health and Human Services, Rockville, MD. 3. Health scientist, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, The Centers for Disease Control and Prevention, Atlanta. 4. Acting director, Office of Population Affairs, U.S. Department of Health and Human Services, Rockville, MD.
Abstract
CONTEXT: Federal and clinical guidelines recommend integrating reproductive life plan assessments into routine family planning encounters to increase provision of preconception care. Yet, the prevalence of clinical protocols and of relevant practices at publicly funded health centers is unknown. METHODS: Administrators and providers at a nationally representative sample of publicly funded health centers that provide family planning services were surveyed in 2013-2014; data from 1,039 linked pairs were used to explore the reported prevalence of reproductive life plan protocols, frequent assessment of patients' reproductive life plan and frequent provision of preconception care. Chi-square tests and multivariable general linear models were used to examine differences in reports of protocols and related practices. RESULTS: Overall, 58% of centers reported having reproductive life plan assessment protocols, 87% reported frequently assessing reproductive life plans and 55% reported frequently providing preconception care. The proportions reporting protocols were lower in community health centers than in other center types (32% vs. 52-91%), in primary care centers than in those with another focus (33% vs. 77-80%) and in centers not receiving Title X funding than in those with such support (36% vs. 77%). Reported existence of a written protocol was positively associated with reported frequent assessment (prevalence ratio, 1.1), and the latter was positively associated with reported frequent preconception care (1.4). CONCLUSION: Further research is needed on associations between written protocols and clinical practice, and to elucidate the preconception care services that may be associated with reproductive life plan assessment.
CONTEXT: Federal and clinical guidelines recommend integrating reproductive life plan assessments into routine family planning encounters to increase provision of preconception care. Yet, the prevalence of clinical protocols and of relevant practices at publicly funded health centers is unknown. METHODS: Administrators and providers at a nationally representative sample of publicly funded health centers that provide family planning services were surveyed in 2013-2014; data from 1,039 linked pairs were used to explore the reported prevalence of reproductive life plan protocols, frequent assessment of patients' reproductive life plan and frequent provision of preconception care. Chi-square tests and multivariable general linear models were used to examine differences in reports of protocols and related practices. RESULTS: Overall, 58% of centers reported having reproductive life plan assessment protocols, 87% reported frequently assessing reproductive life plans and 55% reported frequently providing preconception care. The proportions reporting protocols were lower in community health centers than in other center types (32% vs. 52-91%), in primary care centers than in those with another focus (33% vs. 77-80%) and in centers not receiving Title X funding than in those with such support (36% vs. 77%). Reported existence of a written protocol was positively associated with reported frequent assessment (prevalence ratio, 1.1), and the latter was positively associated with reported frequent preconception care (1.4). CONCLUSION: Further research is needed on associations between written protocols and clinical practice, and to elucidate the preconception care services that may be associated with reproductive life plan assessment.
Authors: Sevilay Temel; Sabine F van Voorst; Brian W Jack; Semiha Denktaş; Eric A P Steegers Journal: Epidemiol Rev Date: 2013-08-28 Impact factor: 6.222
Authors: Marion W Carter; Loretta Gavin; Lauren B Zapata; Marta Bornstein; Nancy Mautone-Smith; Susan B Moskosky Journal: Contraception Date: 2016-04-25 Impact factor: 3.375
Authors: Cheryl L Robbins; Loretta Gavin; Lauren B Zapata; Marion W Carter; Christina Lachance; Nancy Mautone-Smith; Susan B Moskosky Journal: Am J Prev Med Date: 2016-03-24 Impact factor: 5.043
Authors: Julia A Files; Keith A Frey; Paru S David; Katherine S Hunt; Brie N Noble; Anita P Mayer Journal: J Midwifery Womens Health Date: 2011-08-11 Impact factor: 2.388
Authors: Deirdre A Quinn; Stephanie W Edmonds; Xinhua Zhao; Sonya Borrero; Ginny L Ryan; Laurie C Zephyrin; Lisa S Callegari Journal: Matern Child Health J Date: 2021-04-30