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在西雅图的学校健康中心提供长效可逆避孕服务:促进实施的关键主题

Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

作者信息

Gilmore Kelly, Hoopes Andrea J, Cady Janet, Amies Oelschlager Anne-Marie, Prager Sarah, Vander Stoep Ann

机构信息

Department of Health Services, School of Public Health, University of Washington, Seattle, Washington.

Department of Health Services, School of Public Health, University of Washington, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington.

出版信息

J Adolesc Health. 2015 Jun;56(6):658-65. doi: 10.1016/j.jadohealth.2015.02.016.


DOI:10.1016/j.jadohealth.2015.02.016
PMID:26003582
Abstract

PURPOSE: The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners. METHODS: We conducted 14 semistructured interviews with key informants involved in the implementation of LARC services. Key informants included SBHC clinicians and administrators, public health officials, and community partners. We used a content analysis approach to analyze interview transcripts for themes. We explored barriers to and facilitators of LARC service delivery across and within key informant groups. RESULTS: The most cited barriers across key informant groups were as follows: perceived lack of provider procedural skills and bias and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC administrative staff. CONCLUSIONS: LARC counseling and procedural services can be implemented in an SBHC setting to promote access to effective contraceptive options for adolescent women.

摘要

目的:本研究的目的是描述一项在学校健康中心(SBHCs)提供长效可逆避孕(LARC)服务的项目的实施情况,并确定SBHC临床医生和管理人员、公共卫生官员以及社区合作伙伴报告的实施障碍和促进因素。 方法:我们对参与LARC服务实施的关键信息提供者进行了14次半结构化访谈。关键信息提供者包括SBHC临床医生和管理人员、公共卫生官员以及社区合作伙伴。我们采用内容分析方法来分析访谈记录中的主题。我们探讨了关键信息提供者群体之间以及群体内部LARC服务提供的障碍和促进因素。 结果:关键信息提供者群体中最常被提及的障碍如下:认为提供者缺乏操作技能,以及对LARC方法存在偏见和消极态度。各群体中确定的最常见促进因素如下:明确的沟通策略、避孕咨询实践的改变、提供者培训以及利益相关者的参与。在特定的关键信息提供者群体中还出现了另外两个障碍。SBHC行政人员、社区合作伙伴和公共卫生官员大量提及了LARC服务提供的技术和后勤障碍。费用和计费是SBHC行政人员面临的主要障碍。 结论:LARC咨询和程序服务可以在SBHC环境中实施,以促进青少年女性获得有效的避孕选择。

相似文献

[1]
Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

J Adolesc Health. 2015-6

[2]
Knowledge and Acceptability of Long-Acting Reversible Contraception Among Adolescent Women Receiving School-Based Primary Care Services.

J Prim Care Community Health. 2016-7

[3]
Interdependent Barriers to Providing Adolescents with Long-Acting Reversible Contraception: Qualitative Insights from Providers.

J Pediatr Adolesc Gynecol. 2016-10

[4]
Barriers to Health Care Providers' Provision of Long-Acting Reversible Contraception to Adolescent and Nulliparous Young Women.

Nurs Womens Health. 2017

[5]
Integrating Long-Acting Reversible Contraception Services into New York City School-Based Health Centers: Quality Improvement to Ensure Provision of Youth-Friendly Services.

J Pediatr Adolesc Gynecol. 2017-6

[6]
Integration of Onsite Long-Acting Reversible Contraception Services Into School-Based Health Centers.

J Sch Health. 2019-1-13

[7]
Understanding the low uptake of long-acting reversible contraception by young women in Australia: a qualitative study.

BMC Womens Health. 2015-9-10

[8]
Facilitators and Barriers to Implementation of Long-Acting Reversible Contraceptive Services for Adolescent Girls and Young Women in Gaborone, Botswana.

J Pediatr Adolesc Gynecol. 2021-8

[9]
Attitudes toward long-acting reversible contraception among young women seeking abortion.

J Womens Health (Larchmt). 2011-9-16

[10]
A Qualitative Study of Factors That Influence Contraceptive Choice among Adolescent School-Based Health Center Patients.

J Pediatr Adolesc Gynecol. 2016-6

引用本文的文献

[1]
Barriers and facilitators to contraception provision among rural healthcare providers.

Contracept Reprod Med. 2025-3-10

[2]
"The thing in my arm": Providing contraceptive services for adolescents in primary care.

Womens Health (Lond). 2024

[3]
Assessing readiness to implement long-acting injectable HIV antiretroviral therapy: provider and staff perspectives.

Implement Sci Commun. 2023-10-19

[4]
Low Use of Long-Acting Reversible Contraceptives in Tanzania: Evidence from the Tanzania Demographic and Health Survey.

Int J Environ Res Public Health. 2022-4-1

[5]
A comparison of contraceptive services for adolescents at school-based versus community health centers in Oregon.

Health Serv Res. 2022-2

[6]
Evaluation of the Delaware Contraceptive Access Now (DelCAN) initiative: A qualitative analysis of site leaders' implementation recommendations.

Contraception. 2021-8

[7]
Municipal contraceptive services, socioeconomic status and teenage pregnancy in Finland: a longitudinal study.

BMJ Open. 2021-2-17

[8]
Determinants of long acting reversible contraception utilization in Northwest Ethiopia: An institution-based case control study.

PLoS One. 2020-10-20

[9]
Youth-Friendly Family Planning Services for Young People: A Systematic Review Update.

Am J Prev Med. 2018-11

[10]
Knowledge and Acceptability of Long-Acting Reversible Contraception Among Adolescent Women Receiving School-Based Primary Care Services.

J Prim Care Community Health. 2016-7

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