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Kroelinger CD, Pagano HP, DeSisto CL, Estrich C, Romero L, Pliska E, Akbarali S, Velonis A, Cox S. Increasing Access to Contraception: Examining Barriers and Facilitators of Long-Acting Reversible Contraception. J Womens Health (Larchmt) 2024; 33:52-61. [PMID: 37971864 PMCID: PMC10841967 DOI: 10.1089/jwh.2023.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Objective(s): To identify barriers and facilitators related to reimbursement processes, device acquisition costs, stocking, and supply of long-acting reversible contraception (LARC) from 27 jurisdictions (26 states/1 territory) participating in the Increasing Access to Contraception Learning Community from 2016 to 2018. Materials and Methods: A descriptive study using qualitative data collected through 27 semistructured key informant interviews was conducted during the final year of the learning community among all jurisdictional teams. Excerpts were extracted and coded by theme, then summarized as barriers or facilitators using implementation science methods. Results: Most jurisdictions (89%) identified barriers to reimbursement processes, device acquisition, stocking, and supply of LARC devices, and 85% of jurisdictions identified facilitators for these domains. Payment methodology challenges and lack of billing and coding processes were identified as the most common barriers to reimbursement processes. Device acquisition cost challenges and lack of delivery facility protocols for billing were the most common barriers to device acquisition, stocking, and supply of LARC. The most common facilitator of reimbursement processes was expanded payment methodology options, whereas supplemental funding for acquisition costs and protocol development were identified as the most common facilitators of device acquisition, stocking, and supply. Conclusion: Revised payment methodologies and broader health systems changes including additional funding sources and protocols for billing, stocking, and supply were used by learning community jurisdictions to address identified barriers. The learning community framework offers a forum for information exchange, peer-to-peer learning, and sharing of best practices to support jurisdictions in addressing identified barriers and facilitators affecting contraception access.
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Affiliation(s)
- Charlan D. Kroelinger
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - H. Pamela Pagano
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carla L. DeSisto
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Cameron Estrich
- Division of Community Health Sciences, School of Public Health, University of Chicago, Chicago, Illinois, USA
| | - Lisa Romero
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ellen Pliska
- Association of State and Territorial Health Officials, Arlington, Virginia, USA
| | - Sanaa Akbarali
- Association of State and Territorial Health Officials, Arlington, Virginia, USA
| | - Alisa Velonis
- Division of Community Health Sciences, School of Public Health, University of Chicago, Chicago, Illinois, USA
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Estrich C, DeSisto CL, Uesugi K, Akbarali S, Pliska ES, Romero L, Cox S, Kroelinger CD, Velonis A. Use of a Learning Community to Expand Access to Contraception. Am J Public Health 2022; 112:S523-S527. [PMID: 35767792 PMCID: PMC9827430 DOI: 10.2105/ajph.2022.306823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 01/13/2023]
Abstract
The Increasing Access to Contraception Learning Community was established to disseminate strategies and best practices to support 27 jurisdictions in the development of policies and programs to increase access to the full range of reversible contraceptives. We describe Learning Community activities and identify those that were most useful to participants. Although participation in Learning Community provided jurisdictional teams with structured activities such as virtual learning and peer networking opportunities, some teams struggled with full participation because of staffing turnover and shifts in priorities. (Am J Public Health. 2022;112(S5):S523-S527. https://doi.org/10.2105/AJPH.2022.306823).
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Affiliation(s)
- Cameron Estrich
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Carla L DeSisto
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Keriann Uesugi
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Sanaa Akbarali
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Ellen S Pliska
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Lisa Romero
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Shanna Cox
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Charlan D Kroelinger
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
| | - Alisa Velonis
- Cameron Estrich, Carla L. DeSisto, Keriann Uesugi, and Alisa Velonis are with the School of Public Health, University of Illinois, Chicago. Carla L. DeSisto, Lisa Romero, Shanna Cox, and Charlan D. Kroelinger are with the Centers for Disease Control and Prevention, Atlanta, GA. Sanaa Akbarali and Ellen S. Pliska are with the Association of State and Territorial Health Officials, Arlington, VA. Sanaa Akbarali and Ellen S. Pliska are also guest editors for this supplement issue
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