Emily A Hurley1,2,3, Alex Duello4, Sarah Finocchario-Kessler3, Kathy Goggin1,2,5, Stephani Stancil6, Rachel P Winograd4, Melissa K Miller2,7. 1. Division of Health Services and Outcomes Research, Children's Mercy Hospitals and Clinics, Kansas City, MO, USA. 2. Department of Pediatric, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA. 3. Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA. 4. Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO, USA. 5. School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA. 6. Dvisions of Adolescent Medicine and Clinical Pharmacology, Children's Mercy Kansas City, Kansas City, MO, USA. 7. Emergency Medicine, Children's Mercy Kansas City, Kansas City, MO, USA.
Abstract
PURPOSE: 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. APPROACH: In-depth qualitative interviews. SETTING: Three diverse catchment areas in Missouri. PARTICIPANTS: 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. METHOD: Interviews were audio-recorded, transcribed, and thematically coded using Dedoose software. RESULTS: 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. CONCLUSION: 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.
PURPOSE: 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. APPROACH: In-depth qualitative interviews. SETTING: Three diverse catchment areas in Missouri. PARTICIPANTS: 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. METHOD: Interviews were audio-recorded, transcribed, and thematically coded using Dedoose software. RESULTS: 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. CONCLUSION: 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.
Entities:
Keywords:
community settings; contraception access; harm reduction; health disparities; long-acting reversible contraception; neonatal abstinence syndrome; opioid use disorder; qualitative research; substance use
Authors: Mishka Terplan; Dennis J Hand; Melissa Hutchinson; Elizabeth Salisbury-Afshar; Sarah H Heil Journal: Prev Med Date: 2015-04-18 Impact factor: 4.018
Authors: Jianghong Li; Margaret R Weeks; Stephen P Borgatti; Scott Clair; Julia Dickson-Gomez Journal: Subst Use Misuse Date: 2012-04 Impact factor: 2.164
Authors: Lauren Jessell; Pedro Mateu-Gelabert; Honoria Guarino; Sheila P Vakharia; Cassandra Syckes; Elizabeth Goodbody; Kelly V Ruggles; Sam Friedman Journal: J Interpers Violence Date: 2015-08-03
Authors: Elizabeth A Samuels; Steven L Bernstein; Brandon D L Marshall; Maxwell Krieger; Janette Baird; Michael J Mello Journal: J Subst Abuse Treat Date: 2018-08-01
Authors: Sarah C Haight; Jean Y Ko; Van T Tong; Michele K Bohm; William M Callaghan Journal: MMWR Morb Mortal Wkly Rep Date: 2018-08-10 Impact factor: 17.586
Authors: Rebecca L Fischbein; Bethany G Lanese; Lynn Falletta; Kelsey Hamilton; Jennifer A King; Deric R Kenne Journal: Contracept Reprod Med Date: 2018-03-27
Authors: Stephani L Stancil; Melissa K Miller; Alex Duello; Sarah Finocchario-Kessler; Kathy Goggin; Rachel P Winograd; Emily A Hurley Journal: Harm Reduct J Date: 2021-08-04