Sawyer Ashlee N, Kwitowski Melissa A, Benotsch Eric G
1 Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
Am J Health Promot. 2018 May;32(4):906-915. doi: 10.1177/0890117117736091. Epub 2017 Nov 9.
Sexual and reproductive health conditions (eg, infections, cancers) represent public health concerns for American women. The present study examined how knowledge of the Patient Protection and Affordable Care Act (PPACA) relates to receipt of preventive reproductive health services among women.
Cross-sectional online survey.
Online questionnaires were completed via Amazon Mechanical Turk, a crowdsourcing website where individuals complete web-based tasks for compensation.
Cisgendered women aged 18 to 44 years (N = 1083) from across the United States.
Participants completed online questionnaires assessing demographics, insurance status, preventive service use, and knowledge of PPACA provisions.
Chi-squares showed that receipt of well-woman, pelvic, and breast examinations, as well as pap smears, was related to insurance coverage, with those not having coverage at all during the previous year having significantly lower rates of use. Hierarchical logistic regressions determined the independent relationship between PPACA knowledge and use of health services after controlling for demographic factors and insurance status.
Knowledge of PPACA provisions was associated with receiving well-woman, pelvic, and breast examinations, human papillomavirus vaccination, and sexually transmitted infections testing, after controlling for these factors. Results indicate that expanding knowledge about health-care legislation may be beneficial in increasing preventive reproductive health service use among women.
Current findings provide support for increasing resources for outreach and education of the general population about the provisions and benefits of health-care legislation, as well as personal health coverage plans.
性与生殖健康状况（如感染、癌症）是美国女性面临的公共卫生问题。本研究探讨了对《患者保护与平价医疗法案》（PPACA）的了解与女性接受预防性生殖健康服务之间的关系。
横断面在线调查。
在线问卷通过亚马逊土耳其机器人（Amazon Mechanical Turk）完成，这是一个众包网站，个人通过完成基于网络的任务获得报酬。
来自美国各地的18至44岁的顺性别女性（N = 1083）。
参与者完成在线问卷，评估人口统计学特征、保险状况、预防性服务使用情况以及对PPACA条款的了解。
卡方检验表明，接受妇科检查、盆腔检查、乳房检查以及巴氏涂片检查与保险覆盖情况有关，前一年完全没有保险覆盖的人使用率显著较低。分层逻辑回归在控制人口统计学因素和保险状况后，确定了PPACA知识与医疗服务使用之间的独立关系。
在控制这些因素后，对PPACA条款的了解与接受妇科检查、盆腔检查、乳房检查、人乳头瘤病毒疫苗接种以及性传播感染检测有关。结果表明扩大对医疗保健立法的了解可能有助于增加女性预防性生殖健康服务的使用。
当前研究结果支持增加资源，用于向普通人群宣传医疗保健立法的条款、益处以及个人健康保险计划。
