Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD 20814, USA.
Int J Environ Res Public Health. 2023 Feb 17;20(4):3592. doi: 10.3390/ijerph20043592.
The COVID-19 pandemic introduced urgent and unique challenges to family planning providers and staff in ensuring continued access to high-quality services, particularly for groups who experience greater barriers to accessing services, such as women with systemically marginalized identities and adolescents and young adults (AYA). While research has documented key adaptations made to service delivery during the early phase of the pandemic, limited studies have used qualitative methods. This paper draws on qualitative interview data from family planning providers and staff in Title-X-funded clinics and school-based clinics-two settings that serve populations that experience greater barriers to accessing care-to (a) describe the adaptations made to service delivery during the first year of the pandemic and (b) explore provider and staff experiences and impressions implementing these adaptations. In-depth interviews were conducted with 75 providers and staff between February 2020 and February 2021. Verbatim transcripts were analyzed via inductive content analysis followed by thematic analysis. Four key themes were identified: (1) Title-X- and school-based staff made multiple, concurrent adaptations to continue family planning services; (2) providers embraced flexibility for patient-centered care; (3) school-based staff faced unique challenges to reaching and serving youth; and (4) COVID-19 created key opportunities for innovation. The findings suggest several lasting changes to family planning service delivery and provider mindsets at clinics serving populations hardest hit by the pandemic. Future studies should evaluate promising practices in family planning service delivery-including telehealth and streamlined administrative procedures-and explore how these are experienced by diverse patient populations, particularly AYA and those in areas where privacy or internet access are limited.
COVID-19 大流行给计划生育服务提供者和工作人员带来了紧迫和独特的挑战，需要确保他们能够继续获得高质量的服务，尤其是对于那些在获取服务方面面临更大障碍的群体，例如具有系统性边缘化身份的妇女以及青少年和年轻成年人（AYA）。虽然研究已经记录了在大流行早期阶段为服务提供所做的关键调整，但很少有研究使用定性方法。本文借鉴了计划生育服务提供者和工作人员在 Title-X 资助诊所和学校诊所的定性访谈数据——这两个环境服务于那些在获取护理方面面临更大障碍的人群——（a）描述大流行第一年期间服务提供所做的调整，以及（b）探讨提供者和工作人员实施这些调整的经验和印象。在 2020 年 2 月至 2021 年 2 月期间，对 75 名提供者和工作人员进行了深入访谈。对逐字记录进行了归纳内容分析，然后进行了主题分析。确定了四个关键主题：（1）Title-X 和学校工作人员为继续提供计划生育服务做出了多项同时进行的调整；（2）提供者接受了以患者为中心的护理的灵活性；（3）学校工作人员在接触和服务青年方面面临独特的挑战；（4）COVID-19 为创新创造了关键机会。研究结果表明，在为受大流行影响最严重的人群提供服务的诊所中，计划生育服务提供和提供者思维方式发生了一些持久的变化。未来的研究应该评估计划生育服务提供方面有前途的实践，包括远程医疗和简化的行政程序，并探讨这些实践在不同患者群体中的体验，特别是 AYA 和那些隐私或互联网接入受到限制的地区。
