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Long-acting reversible contraceptive use among urban, low-income women

Charlene Collier, Yale University School of Medicine, 2012

Project abstract

Long-acting reversible contraceptive methods (LARC) provide highly effective pregnancy protection but are underused among low-income, minority women in the US, who have disproportionally higher rates of unintended pregnancies. Greater public health efforts are necessary to decrease barriers to acceptance and use of LARC methods in this population.

Community-based organizations can play a greater role helping women access family planning services. Healthy Start provides comprehensive care-coordination and support to mothers from underserved communities, and their care-coordinators are in a unique position to establish long-term relationships with participants, understand their motivations and barriers to family planning and help them access services. There is no research about how Healthy Start can impact women's knowledge, access and use of LARC methods.

Our study uses community-based participatory research with New Haven Healthy Start (NHHS) to assess LARC acceptance and use in an urban, low-income population. The research team involves NHHS care-coordinators and participants, clinicians and mixed-methods researchers to complete four study components:

  1. A survey on LARC use among medical providers of low-income women in New Haven, CT
  2. In-depth interviews about care-coordinators' perspectives on family planning
  3. A survey of NHHS participants' knowledge and acceptance of LARC
  4. Development and assessment of a comprehensive strategy to strengthen NHHS family planning efforts

The findings of this research could be applied to the national network of Healthy Start providers, care coordinators and women of low-income and minority communities and could strengthen the capacity of Healthy Start to help women prevent unintended pregnancies.


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