Harper C, Balistreri E, Boggess J, Leon K, Darney P
Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, USA.
Fam Plann Perspect. 2001 Jan-Feb;33(1):13-8.
First Stop, an 18-month demonstration project that operated in 1996-1997, was designed to offer low-income adult women in California hormonal contraceptives without requiring a pelvic examination.
An evaluation was undertaken to assess the contraceptives adopted by First Stop clients, compare health risks of these women with risks among women using traditional family planning clinics and assess clients'satisfaction. Data on 2,065 First Stop clients and 1,507 women attending traditional clinics were collected through several self- and clinician-administered instruments, including questionnaires, a telephone survey and medical chart abstractions.
After the initial First Stop visit, 38% of women adopted a more effective method than they had used at last sex, 4 7% remained with the same method, 12% switched to a less-effective method and 3% accepted no method. Of clients who were referred for additional medical care, 73% followed through on their referrals. Compared with clients at traditional clinics, First Stop clients were less likely to have a regular source of health care, but more likely to have made a health care visit in the past year. Most First Stop clients valued the project's services; 76% said it was important to be able to receive pills or injections without a pelvic examination.
Programs that provide hormonal contraceptives without requiring a pelvic examination can expand low-income women's access to these methods and improve the chances that they will obtain other reproductive health services.
“第一站”是一个在1996 - 1997年开展的为期18个月的示范项目，旨在为加利福尼亚州的低收入成年女性提供激素避孕措施，且无需进行盆腔检查。
进行了一项评估，以评估“第一站”的客户采用的避孕措施，将这些女性的健康风险与使用传统计划生育诊所的女性的风险进行比较，并评估客户的满意度。通过几种自我管理和临床医生管理的工具收集了2065名“第一站”客户和1507名在传统诊所就诊的女性的数据，包括问卷、电话调查和病历摘要。
在首次访问“第一站”后，38%的女性采用了比她们上次性行为时使用的更有效的方法，47%的女性保持使用相同的方法，12%的女性改用了效果较差的方法，3%的女性未采用任何方法。在被转介接受额外医疗护理的客户中，73%的人接受了转介。与传统诊所的客户相比，“第一站”的客户不太可能有固定的医疗保健来源，但在过去一年中更有可能去看过病。大多数“第一站”的客户重视该项目的服务；76%的人表示能够在不进行盆腔检查的情况下获得避孕药丸或注射剂很重要。
提供无需盆腔检查的激素避孕措施的项目可以扩大低收入女性获得这些方法的机会，并提高她们获得其他生殖健康服务的可能性。
