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Routh D, Simmons R, Sanders J, Gero A, Tanner HA, Turok DK. Building an implementation framework to address unmet contraceptive care needs in a carceral setting: a systematic review. HEALTH & JUSTICE 2023; 11:43. [PMID: 37861888 PMCID: PMC10588068 DOI: 10.1186/s40352-023-00243-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The provision of contraceptive care for incarcerated individuals has been largely inconsistent and has contributed to, at best, inadequate care, and at worst reproductive abuses, violence, and coercion. While previous research has identified strategies to remedy known issues, to date, very few recommendations have been implemented across the carceral system. To address this, we conducted a systematic review of policy and practice recommendations to improve contraceptive care to reproductive-aged, incarcerated individuals in the United States. METHODS We conducted this systematic review utilizing the Joanna Briggs Institute methodology and framed it within the National Implementation Research Network's (NIRN) Exploration stage. We searched PubMed, PSYCInfo, SCOPUS, ProQuest, Web of Science, MedLine, Social Science Citation Index and reference sections of included materials. Basic study information, explicitly stated policy and practice recommendations, and discussions and conclusions that subtly provide recommendations were extracted in full text. We utilized a thematic analysis approach to analyze the extracted text. RESULTS A total of 45 materials met the inclusion criteria. Seven overarching themes were identified: 1) policy changes needed to implement care; 2) need for contraceptive care in carceral systems; 3) justice agency barriers regarding contraceptive care provision; 4) policy barriers to contraceptive access; 5) funding strategies to improve care; 6) patient preferences for contraceptive care delivery; and 7) healthcare provider knowledge regarding contraceptive care. The seven themes identified shed light on the need for, gaps, barriers, and facilitators of current contraceptive care provision to incarcerated individuals. CONCLUSION This systematic review accomplished two goals of NIRN's Exploration stage. First, the compiled evidence identified a clear need for change regarding policies and practices pertaining to contraceptive care provision to incarcerated individuals in the United States. Second, our findings identified several evidence-based solutions supported both by research and professional healthcare organizations to address the identified need for change. This study provides an initial blueprint for correctional agencies to implement the necessary changes for improving contraceptive care provision to incarcerated populations. The correctional system is in a unique position to deliver much-needed care, which would result in many potential benefits to the individuals, correctional system, and community at large.
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Affiliation(s)
- Douglas Routh
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA.
| | - Rebecca Simmons
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - Jessica Sanders
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - Alexandra Gero
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - Hannah Aanderud Tanner
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
| | - David K Turok
- Division of Family Planning, Department of Obstetrics & Gynecology, University of Utah School of Medicine, 30 N 1900 E, Room 2B200, Salt Lake City, UT, 84132, USA
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Ely GE, Linn BK, Staton M, Hales TW, Agbemenu K, Maguin E. Contraceptive use in Appalachian women who use drugs and were recruited from rural jails. SOCIAL WORK IN HEALTH CARE 2020; 59:365-386. [PMID: 32614736 PMCID: PMC7337968 DOI: 10.1080/00981389.2020.1769249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
This study describes a secondary data analysis of contraceptive use across the lifetime and within the six months prior to incarceration in a sample of 400 currently incarcerated women recruited from rural, Appalachian jails, who were using drugs prior to incarceration. Phase 1 (baseline) data from an NIH funded study were used to examine rates of contraceptive use, reasons for nonuse of condoms, and correlates of condom use. Results indicate that the majority (96.5%) of respondents reported lifetime use of contraceptives, and most (70.5%) had a history of using multiple methods, with male condoms, oral contraceptive pills, and contraceptive injections being the most commonly used methods. Almost 69% of respondents reported nonuse of contraceptives within the last six months, despite high rates of involvement in risky, intimate male partnerships prior to incarceration. Contraceptive use was found to be historically acceptable in this sample, in stark contrast to rates of use within the last six months prior to incarceration, suggesting that reproductive justice-informed, social work interventions to help improve current contraceptive use are warranted as a harm-reduction approach.
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Affiliation(s)
- Gretchen E Ely
- School of Social Work, University at Buffalo, The State University of New York , Buffalo, NY, USA
| | - Braden K Linn
- Clinical and Research Institute on Addictions, University at Buffalo , Buffalo, NY, USA
| | - Michele Staton
- College of Medicine, Department of Behavioral Sciences, University of Kentucky , Lexington, KY, USA
| | - Travis W Hales
- School of Social Work, University at North Carolina-Charlotte , Charlotte, NC, USA
| | | | - Eugene Maguin
- Department of Psychology, University at Buffalo , Buffalo, NY, USA
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Handy CJ, Lange HLH, Manos BE, Berlan ED, Bonny AE. A Retrospective Chart Review of Contraceptive Use among Adolescents with Opioid Use Disorder. J Pediatr Adolesc Gynecol 2018; 31:122-127. [PMID: 29162530 PMCID: PMC5866180 DOI: 10.1016/j.jpag.2017.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/26/2017] [Accepted: 11/11/2017] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE To describe contraceptive use among female adolescents initiating outpatient treatment for opioid use disorder. DESIGN Retrospective chart review. SETTING Outpatient clinic providing medication-assisted treatment for substance use disorders to adolescents and young adults. PARTICIPANTS Nonpregnant female adolescents who presented for treatment from January 1, 2013 to January 31, 2016 (N = 123). INTERVENTIONS None. MAIN OUTCOME MEASURES Prescription contraceptive use at baseline and initiation of a new method within 90 days. RESULTS Of 123 female adolescents who presented for treatment of opioid use disorder, 113 (91.9%) reported sexual activity and 80 (65.0%) were not using prescription contraception at intake. Previous pregnancy was reported by 43 (35.0%) and 20 (16.3%) were positive for a sexually transmitted infection. Contraceptive counseling was not documented for 73 (59.3%) patients. Among patients with no prescription contraception at baseline, 56 of 80 (70.0%) initiated a method within the study window. Significant predictors (odds ratio [OR]; 95% confidence interval) of contraceptive initiation included previous pregnancy (8.6; 1.39-52.99), education of less than a high school diploma/general equivalency diploma (7.4; 1.63-33.41), and return for follow-up visit (9.8; 2.18-43.69). CONCLUSION Young women who presented for opioid use disorder treatment were at high risk of adverse reproductive health outcomes. Most were sexually active and not using prescription contraception. Findings underscore the need for contraceptive counseling in this patient population. Optimally, these services would be provided in conjunction with substance use treatment. Improved contraceptive counseling documentation will allow evaluation of effective contraceptive counseling strategies for adolescents with opioid use disorders and might serve to inform future interventions.
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Affiliation(s)
- Caitlin J Handy
- The Ohio State University College of Medicine, Columbus, Ohio
| | - Hannah L H Lange
- The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
| | - Brittny E Manos
- The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Elise D Berlan
- The Ohio State University College of Medicine, Columbus, Ohio; Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Andrea E Bonny
- The Ohio State University College of Medicine, Columbus, Ohio; The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio
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Diehl A, Pillon SC, Santos MAD, Laranjeira R. Abortion and sex-related conditions in substance-dependent Brazilian patients. CAD SAUDE PUBLICA 2017; 33:e00143416. [PMID: 29166482 DOI: 10.1590/0102-311x00143416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 02/06/2017] [Indexed: 01/27/2023] Open
Abstract
Abortion is a very sensitive issue with relevance to public health; however few clinical or population-based studies have examined induced abortion among drug users. The study aims to evaluate the prevalence of induced abortion and sex-related conditions in an inpatient drug user sample. A cross-sectional design study was conducted in an inpatient addiction treatment unit in São Paulo, Brazil, with a sample of 616 patients, aged 18-75. Sociodemographic data, sexual behavior, and dependence severity were evaluated in relation to induced abortion. Approximately 27% of patients reported having a history of abortion (themselves in the case of women or partners in the case of men). The mean age was 34.6±10.9 years old, 34.9% diagnosed with severe alcohol dependence, 33% were diagnosed with severe levels of dependence on other drugs, 69.6% were diagnosed cocaine users (inhaled and smoked), and alcohol was the drug of choice for 30.4%. Chances of having a history of abortion is greater for women than for men with a odds ratio (OR = 2.9; 95%CI: 1.75-4.76), (OR = 1.7; 95%CI: 1.09-2.75) of no condom use; (OR = 2.0; 95%CI: 1.35-3.23) of history of STI and (OR = 3.2; 95%CI: 1.29-5.73) use of morning-after pill. Drug- and alcohol-dependent patients have high-risk behaviours of sporadic use or no-condom use which contribute to unplanned pregnancy and induced abortion, making this vulnerable population a group which deserves special attention in sexual health prevention programmes and health promotion efforts for the reduction of induced abortion.
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Affiliation(s)
- Alessandra Diehl
- Unidade de Pesquisa em Álcool e Drogas, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Sandra Cristina Pillon
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Manoel Antonio Dos Santos
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | - Ronaldo Laranjeira
- Unidade de Pesquisa em Álcool e Drogas, Universidade Federal de São Paulo, São Paulo, Brasil
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Edelman NL, Patel H, Glasper A, Bogen-Johnston L. Sexual health risks and health-seeking behaviours among substance-misusing women. J Adv Nurs 2014; 70:2861-70. [DOI: 10.1111/jan.12442] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2014] [Indexed: 11/26/2022]
Affiliation(s)
| | - Harish Patel
- Hastings Sexual Health Clinic; Hastings & Rother Primary Care Trust; Hastings UK
| | - Anthony Glasper
- Hastings Substance Misuse Service; Sussex Partnership NHS Foundation Trust; Worthing UK
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Clinical features and correlates of outcomes for high-risk, marginalized mothers and newborn infants engaged with a specialist perinatal and family drug health service. Obstet Gynecol Int 2012; 2012:867265. [PMID: 23227054 PMCID: PMC3512313 DOI: 10.1155/2012/867265] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 09/26/2012] [Indexed: 11/18/2022] Open
Abstract
Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined. Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%). Pregnancy complications were common (61.9%). Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8%) and almost half required pharmacotherapy. Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development.
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Black KI, Stephens C, Haber PS, Lintzeris N. Unplanned pregnancy and contraceptive use in women attending drug treatment services. Aust N Z J Obstet Gynaecol 2012; 52:146-50. [DOI: 10.1111/j.1479-828x.2012.01413.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 12/25/2011] [Indexed: 01/06/2023]
Affiliation(s)
- Kirsten I. Black
- Discipline of Obstetrics, Gynaecology and Neonatology; Central Clinical School, Royal Prince Alfred Hospital, University of Sydney; Camperdown
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Burns L, Mattick RP. Using population data to examine the prevalence and correlates of neonatal abstinence syndrome. Drug Alcohol Rev 2009; 26:487-92. [PMID: 17701511 DOI: 10.1080/09595230701494416] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of this study was to determine the population prevalence and correlates of neonatal abstinence syndrome among neonates born to women on methadone, using a cross-sectional analysis of linked population health data. A total of 2941 live births to women actively on methadone at delivery were analysed over an 11-year period (1992 - 2002). Of these births, 796 neonates (27%) were diagnosed with an International Classification of Diseases - 9CM (ICD-9CM) or International Classification of Diseases ICD - 10AM (ICD-10AM) diagnosis related to neonatal withdrawal from exposure to opiates in utero (NAS). There were significant differences found between mothers whose neonates did and did not receive an International Classification of Diseases NAS-related diagnosis. Mothers of neonates with a NAS-related diagnosis had a higher number of previous pregnancies, were more likely to be indigenous, to smoke more heavily and were more likely to present for delivery unbooked. Neonates diagnosed with NAS were admitted to Special Care Nursery more often. NAS is diagnosed less frequently using International Classification of Diseases (ICD) codes than when using clinical scales measuring opiate-related neonatal withdrawal. This suggests that NAS may be under-represented in hospital morbidity databases that use ICD codes to quantify patient throughput and in some circumstances this may result from under-detection of the condition. Future research should therefore seek to determine the validity of NAS recording in hospital morbidity databases reliant on the use ICD codes.
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Affiliation(s)
- Lucy Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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Kirby D. The impact of programs to increase contraceptive use among adult women: a review of experimental and quasi-experimental studies. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2008; 40:34-41. [PMID: 18318870 DOI: 10.1363/4003408] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
CONTEXT Because rates of unintended pregnancy, abortion and unintended birth are very high among adult women in the United States, it is important to identify interventions that can increase contraceptive use in this population. METHODS PubMed, PsycINFO and POPLINE were searched for experimental or quasi-experimental studies published between 1990 and 2005 that evaluated policies or programs designed to increase contraceptive use or reduce pregnancy among adult women in the United States. In addition, relevant journals were searched, experts were asked to provide further citations and several subsequently published articles were included. RESULTS Only 11 studies that assessed programs, and none that assessed policies, were found. The evaluated interventions offered pregnancy and STD prevention counseling (one study); provided contraceptives in settings other than family planning clinics (two studies); had women initiate contraceptive use during the medical visit (two studies); provided advance supplies of emergency contraception (four studies); or implemented systems to remind injectable contraceptive users about their next injection (two studies). The interventions generally had positive, albeit short-term, effects on contraceptive use; none reduced pregnancy rates. Programs that gave women a contraceptive during the visit were the most effective at increasing method use. Advance provision of emergency contraception increased the likelihood of its use and did not affect regular contraceptive use. CONCLUSIONS Very few studies have evaluated interventions to increase contraceptive use among adult women. A research plan that rigorously assesses the impact of different approaches to increasing contraceptive use among adult women should be an integral part of any long-term effort to prevent unintended pregnancy in the United States.
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Abstract
AIMS To examine the obstetric and perinatal outcomes for women with a drug-related hospital admission during pregnancy. DESIGN Antenatal and birth admissions to New South Wales (NSW) hospitals from the NSW Inpatient Statistics Collection were linked to birth information from the NSW Midwives Data Collection over a 5-year period (1998-2002). MEASUREMENTS Birth admissions were flagged as positive for drug use where a birth admission or any pregnancy admission for that birth involved an opioid, cannabis or stimulant-related International Classification of Diseases version 10 Australian modification (ICD-10AM) code. FINDINGS A total of 416 834 live births were analysed over a 5-year period (1998-2002). Of these, 1974 pregnancies had an opioid ICD-10AM diagnosis recorded, 552 a stimulant-related ICD-10AM and 2172 a cannabis ICD-10AM diagnosis. Births in each of the drug groups were to women who were younger, had a higher number of previous pregnancies, were indigenous, smoked heavily and were not privately insured. These women also presented later in their pregnancy to antenatal services and were more likely to arrive at hospital unbooked. Neonates born to women in each of the drug groups were more likely to be premature and were admitted to neonatal intensive care and special care nursery more often, with neonates born to women in the opioid group admitted most often. CONCLUSIONS Linked population level administrative data is a powerful method for examining the maternal and neonatal outcomes associated with the use of specific illicit drugs during pregnancy.
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Affiliation(s)
- Lucy Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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Jessup MA, Brindis CD. Issues in Reproductive Health and Empowerment in Perinatal Women with Substance Use Disorders. J Addict Nurs 2005. [DOI: 10.1080/10884500500196693] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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