Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences
Introduction: Federally qualified health centers (FQHCs) provide essential contraceptive services to low-income individuals; yet, access to all method options, notably intrauterine devices (IUDs) and implants, may be limited at non-Title X FQHCs. The South Carolina (SC) Choose Well initiative is a s...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2021-12-01
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| Series: | Women's Health Reports |
| Subjects: | |
| Online Access: | https://www.liebertpub.com/doi/full/10.1089/WHR.2021.0060 |
| _version_ | 1797345756770729984 |
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| author | Liane M. Ventura Kate E. Beatty Amal J. Khoury Michael G. Smith Oluwatosin Ariyo Deborah L. Slawson Amy J. Weber |
| author_facet | Liane M. Ventura Kate E. Beatty Amal J. Khoury Michael G. Smith Oluwatosin Ariyo Deborah L. Slawson Amy J. Weber |
| author_sort | Liane M. Ventura |
| collection | DOAJ |
| description | Introduction: Federally qualified health centers (FQHCs) provide essential contraceptive services to low-income individuals; yet, access to all method options, notably intrauterine devices (IUDs) and implants, may be limited at non-Title X FQHCs. The South Carolina (SC) Choose Well initiative is a statewide contraceptive access initiative that was launched in 2017 and extends into 2022. Choose Well established a collaborative network between training and clinical partners and is aimed at facilitating implementation of contraceptive care best practices through capacity-building and training of clinical and administrative staff in partner organizations. The initiative provided funding for workforce expansion and contraceptive methods. We examined perceptions of staff from Choose Well-participating FQHCs regarding contraceptive access during the first 2 years of the initiative, including factors that facilitated or posed access challenges as well as sustaining factors. This study informs the process evaluation of Choose Well while providing data critical for uncovering and scaling up contraceptive access initiatives.
Materials and Methods: Interviews were conducted with FQHC staff (n?=?34) in 2018 and 2019 to assess Choose Well implementation and were recorded, transcribed, and double-coded via at least 80% interrater reliability or consensus coding. Data were analyzed according to clinical and administrative factors influencing contraceptive access.
Results: Increased capacity for contraceptive counseling and provision through training and external funding for IUDs and implants were the most noted clinical factors facilitating access. Streamlining workflow processes was also a facilitator. Buy-in and engagement among staff and leadership emerged as a facilitator at some clinics and as a barrier at others. Policy/structural factors related to costs of devices and insurance coverage were identified as threats to sustainability.
Conclusions: The Choose Well initiative contributed to the perception of an increase in contraceptive access at participating FQHCs in SC. Statewide contraceptive access initiatives have the potential to support FQHCs in meeting their clients' contraceptive needs. Organizational buy-in, sustainability of funding, and training are key to realizing the full potential of these initiatives. |
| first_indexed | 2024-03-08T11:23:21Z |
| format | Article |
| id | doaj.art-0c327dbb830443ca8068889d3c83404b |
| institution | Directory Open Access Journal |
| issn | 2688-4844 |
| language | English |
| last_indexed | 2024-03-08T11:23:21Z |
| publishDate | 2021-12-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Women's Health Reports |
| spelling | doaj.art-0c327dbb830443ca8068889d3c83404b2024-01-26T05:40:39ZengMary Ann LiebertWomen's Health Reports2688-48442021-12-012160862010.1089/WHR.2021.0060Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and ExperiencesLiane M. VenturaKate E. BeattyAmal J. KhouryMichael G. SmithOluwatosin AriyoDeborah L. SlawsonAmy J. WeberIntroduction: Federally qualified health centers (FQHCs) provide essential contraceptive services to low-income individuals; yet, access to all method options, notably intrauterine devices (IUDs) and implants, may be limited at non-Title X FQHCs. The South Carolina (SC) Choose Well initiative is a statewide contraceptive access initiative that was launched in 2017 and extends into 2022. Choose Well established a collaborative network between training and clinical partners and is aimed at facilitating implementation of contraceptive care best practices through capacity-building and training of clinical and administrative staff in partner organizations. The initiative provided funding for workforce expansion and contraceptive methods. We examined perceptions of staff from Choose Well-participating FQHCs regarding contraceptive access during the first 2 years of the initiative, including factors that facilitated or posed access challenges as well as sustaining factors. This study informs the process evaluation of Choose Well while providing data critical for uncovering and scaling up contraceptive access initiatives. Materials and Methods: Interviews were conducted with FQHC staff (n?=?34) in 2018 and 2019 to assess Choose Well implementation and were recorded, transcribed, and double-coded via at least 80% interrater reliability or consensus coding. Data were analyzed according to clinical and administrative factors influencing contraceptive access. Results: Increased capacity for contraceptive counseling and provision through training and external funding for IUDs and implants were the most noted clinical factors facilitating access. Streamlining workflow processes was also a facilitator. Buy-in and engagement among staff and leadership emerged as a facilitator at some clinics and as a barrier at others. Policy/structural factors related to costs of devices and insurance coverage were identified as threats to sustainability. Conclusions: The Choose Well initiative contributed to the perception of an increase in contraceptive access at participating FQHCs in SC. Statewide contraceptive access initiatives have the potential to support FQHCs in meeting their clients' contraceptive needs. Organizational buy-in, sustainability of funding, and training are key to realizing the full potential of these initiatives.https://www.liebertpub.com/doi/full/10.1089/WHR.2021.0060Choose Wellcontraceptionfamily planning servicesfederally qualified health centersHealth Services Accessibilitysafety-net providers |
| spellingShingle | Liane M. Ventura Kate E. Beatty Amal J. Khoury Michael G. Smith Oluwatosin Ariyo Deborah L. Slawson Amy J. Weber Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences Women's Health Reports Choose Well contraception family planning services federally qualified health centers Health Services Accessibility safety-net providers |
| title | Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences |
| title_full | Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences |
| title_fullStr | Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences |
| title_full_unstemmed | Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences |
| title_short | Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences |
| title_sort | contraceptive access at federally qualified health centers during the south carolina choose well initiative a qualitative analysis of staff perceptions and experiences |
| topic | Choose Well contraception family planning services federally qualified health centers Health Services Accessibility safety-net providers |
| url | https://www.liebertpub.com/doi/full/10.1089/WHR.2021.0060 |
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