Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Departments of Obstetrics and Gynecology and Reproductive Biology, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
J Rural Health. 2023 Jan;39(1):172-178. doi: 10.1111/jrh.12697. Epub 2022 Jul 13.
To evaluate rural Colorado women's access to and preferences for receiving reproductive health care services.
We conducted an online survey of women ages 18-45 years old. We mailed recruitment postcards to a random sample of female, registered voters in rural Colorado zip codes. Survey questions assessed experiences, beliefs, and preferences regarding reproductive health care. We performed bivariate statistics and logistic regression for predictors of interest in telemedicine.
Respondents (n = 478) had a median age of 34 years (range 18-45). Most women identified as White (90.2%) and were insured (67.1% private; 20.5% public). Most (74.1%) noted barriers to obtaining reproductive care in their communities. Those who reported barriers cited a median of 3 barriers (range 1-8), most commonly too few community-based providers (81.4%) and long distance to care (69.5%). Among respondents, 51.0% had used telemedicine before and 52.5% were interested in using telemedicine for reproductive health services. Interest in telemedicine significantly differed by perceived difficulty accessing care, previous telemedicine use, traveling over 100 miles for medical care in the last year, and belief in the safety of abortion. Those interested in telemedicine were less likely to value having an established relationship with providers and face-to-face visits.
Most reproductive-aged, rural Colorado women endorsed barriers to obtaining reproductive health care in their communities. Over half of rural women are interested in using telemedicine for reproductive health care; however, many are not. Both optimizing telemedicine and developing additional innovative solutions are needed to improve access to reproductive care in rural communities.
评估科罗拉多州农村女性获得和偏好接受生殖健康护理服务的情况。
我们对 18-45 岁的女性进行了在线调查。我们向科罗拉多州农村邮政编码的女性、注册选民随机邮寄了招募明信片。调查问题评估了有关生殖保健服务的经验、信念和偏好。我们对与远程医疗相关的感兴趣的预测因素进行了双变量统计和逻辑回归。
受访者（n=478）的中位数年龄为 34 岁（范围 18-45）。大多数女性为白人（90.2%）并参保（67.1%私人保险；20.5%公共保险）。大多数（74.1%）表示在其社区获得生殖护理存在障碍。报告存在障碍的人提到了中位数为 3 个障碍（范围 1-8），最常见的是社区内提供的服务太少（81.4%）和距离护理地点太远（69.5%）。在受访者中，51.0%以前使用过远程医疗，52.5%对使用远程医疗进行生殖健康服务感兴趣。对远程医疗的兴趣因获得护理的难度、以前使用远程医疗、过去一年因医疗原因旅行超过 100 英里以及对堕胎安全性的看法而有显著差异。对远程医疗感兴趣的人不太重视与提供者建立关系和面对面就诊。
大多数有生育能力的科罗拉多州农村女性认为在其社区获得生殖保健存在障碍。超过一半的农村女性对使用远程医疗进行生殖保健感兴趣；然而，许多人并不感兴趣。需要优化远程医疗并开发其他创新解决方案，以改善农村社区获得生殖保健的机会。
