Stulberg Debra B, Monast Kristie, Dahlquist Irma H, Palmer Kate
Department of Family Medicine, The University of Chicago, Chicago, IL.
Midwest Access Project, Chicago, IL.
Contraception. 2018 Apr;97(4):341-345. doi: 10.1016/j.contraception.2018.01.002. Epub 2018 Jan 12.
The Midwest Access Project (MAP) offers opt-in training to students, residents and practicing clinicians in reproductive health care including abortion. We surveyed MAP alumni to identify current practice characteristics and assess predictors of reproductive health service provision.
We sent an online survey to alumni of MAP's Individual Clinical Training program, 2007-2015 (n=127). The primary outcome was current provision of any abortion service. Secondary outcomes included providing specific abortion services and other reproductive services.
We received responses from 61% of eligible MAP alumni (n=77 out of 127). The majority reported a specialty of Family Medicine (68%) and current location in the Midwest (52%). Among current residents, fellows or clinicians practicing in a field whose scope includes abortion (n=56), 50% provide abortion. Most (84%) provide outpatient miscarriage management, and nearly all (≥96%) provide pregnancy options counseling and full scope contraception. Respondents who received the most advanced training in medication abortion as part of their MAP training were more likely to report providing abortion in their current practice than those who did not (63% vs. 32%, p=.027), as were those who completed more than one MAP rotation compared to those who completed one rotation (100% vs. 44%, p=.009).
Half of MAP's alumni provide some abortion care. Nearly all provide comprehensive counseling and contraceptive services.
Opt-in training is a promising strategy to develop providers of comprehensive reproductive health care.
中西部准入项目（MAP）为学生、住院医师和从事生殖健康护理（包括堕胎）的临床医生提供自愿参与的培训。我们对MAP的校友进行了调查，以确定他们当前的执业特征，并评估提供生殖健康服务的预测因素。
我们向2007 - 2015年MAP个人临床培训项目的校友发送了在线调查问卷（n = 127）。主要结果是目前是否提供任何堕胎服务。次要结果包括提供特定的堕胎服务和其他生殖服务。
我们收到了61%符合条件的MAP校友的回复（127人中77人回复）。大多数人报告其专业为家庭医学（68%），目前位于中西部地区（52%）。在目前从事范围包括堕胎领域的住院医师、研究员或临床医生中（n = 56），50%提供堕胎服务。大多数人（84%）提供门诊流产管理，几乎所有人（≥96%）提供妊娠选择咨询和全面的避孕服务。作为MAP培训的一部分，接受药物流产最先进培训的受访者比未接受此类培训者更有可能报告在其当前执业中提供堕胎服务（63%对32%，p = 0.027），与完成一次MAP轮转的人相比，完成不止一次MAP轮转的人也是如此（分别为100%对44%，p = 0.009）。
MAP的校友中有一半提供某种堕胎护理。几乎所有人都提供全面的咨询和避孕服务。
自愿参与的培训是培养全面生殖健康护理提供者的一种有前景的策略。
