Abstract
In 2016, the NeighborhoodHELP mobile health centers (MHCs) started to provide free long acting reversible contraception (LARC) for uninsured patients who lacked access due to cost. All female patients with appointments from May 1st, 2016 through April 30th, 2017 were identified. LARC uptake rate, as well as demographics for patients aged 15–44 who underwent LARC insertion versus those who did not, were determined. Of the 520 female patients seen on the MHCs during the study period, 170 were of reproductive age. Seventeen (10%) patients opted for LARC; 100 % of these patients spoke Spanish or English and 82 % identified as White and Hispanic/Latino. Results show a 10% LARC uptake, which is slightly above the national rate, but lower than rates in other studies in which cost barriers were removed. Further investigation into barriers influencing LARC uptake in our patient population is warranted.
This is a preview of subscription content, log in via an institution to check access.
References
Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016;374:843–52. https://doi.org/10.1056/NEJMsa1506575.
Cheng D, Schwarz E, Douglas E, Horon I. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception. 2009;79(3):194–8. https://doi.org/10.1016/j.contraception.2008.09.009.
American College of Obstetricians and Gynecologists. Committee opinion. Increasing access to contraceptive implants and intrauterine devices to reduce unintended pregnancy. October 2015. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Increasing-Access-to-Contraceptive-Implants-and-Intrauterine-Devices-to-Reduce-Unintended-Pregnancy. Accessed 24 Nov 2018.
Wu J, Moniz MH, Ursu AN. Long-acting reversible contraception-highly efficacious, safe, and underutilized. JAMA. 2018;320(4):397–8. https://doi.org/10.1001/jama.2018.8877.
Logan C, Holcombe E, Manlove J, et al. The consequences of unintended childbearing: A white paper. Washington: Child Trends, Inc.; 2007 May. https://pdfs.semanticscholar.org/b353/b02ae6cad716a7f64ca48b3edae63544c03e.pdf. Accessed 24 Nov 2018.
Cheng D, Schwarz E, Douglas E, et al. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception. 2009;79(3):194–8.
Kost K, Landry D, Darroch J. Predicting maternal behaviors during pregnancy: does intention status matter? Fam Plan Perspect. 1998;30(2):79–88.
D’Angelo D, Gilbert BC, Rochat R, et al. Differences between mistimed and unwanted pregnancies among women who have live births. Perspect Sex Reprod Health. 2004;36(5):192–7.
Hoffman S, Maynard R, editors. Kids having kids: economic costs and social consequences of teen pregnancy. 2nd ed. Washington: Urban Institute Press; 2008.
Hoffman S. By the numbers: the public costs of teen childbearing. Washington: National Campaign to Prevent Teen Pregnancy; 2006.
Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The contraceptive CHOICE project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010;203(2):115.e1–7. https://doi.org/10.1016/j.ajog.2010.04.017.
Gyllenberg F, Juselius M, Gissler M, Heikinheimo O. Long-acting reversible contraception free of charge, method initiation, and abortion rates in Finland. Am J Public Health. 2018;108(4):538–43. https://doi.org/10.2105/AJPH.2017.304280.
Sanders JN, Myers K, Gawron LM, Simmons RG, Turok DK. Contraceptive method use during the community-wide HER Salt Lake contraceptive initiative. Am J Public Health. 2018;108:550–6. https://doi.org/10.2105/AJPH.2017.304299.
Colorado Department of Public Health and Environment. Taking the unintended out of pregnancy: colorado’s success with long-activing reversible contraception. https://www.colorado.gov/pacific/sites/default/files/PSD_TitleX3_CFPI-Report.pdf. Accessed 18 Aug 2019.
Rock J, Acuna J, Lozano JM, Martinez IL, Greer PJ Jr, Brown DR, Brewster L, Simpson JL. Impact of an academic-community partnership in medical education on community health: evaluation of a novel student-based home visitation program. South Med J. 2014;107(4):203–11. https://doi.org/10.1097/SMJ.0000000000000080.
Bayer US Patient Assistance Foundation. Useful resources. https://www.patientassistance.bayer.us/en/resources/. Accessed 21 Apr 2019.
Nall M, O’Connor S, Hopper T, Peterson H, Mahajan B. Community women and reproductive autonomy: building an infrastructure for long-activing reversible contraception (LARC) services in a mobile health clinic. J Health Care Poor Underserved. 2019;30(1):47–58. https://doi.org/10.1353/hpu.2019.0006.
National Center for Health Statistics. Contraceptive use 2011–2015. https://www.cdc.gov/nchs/fastats/contraceptive.htm. Accessed 28 Nov 2018.
Kavanaugh ML, Jerman J, Lawrence F. Changes in use of long-acting reversible contraceptive methods among U.S. women, 2009–2012. Obstet Gynecol. 2015;126(5):917–27. https://doi.org/10.1097/AOG.0000000000001094.
Jones J, Mosher W, Daniels K. Current contraceptive use in the United States, 2006–2010, and changes in patterns of use since 1995, National Health Statistics Reports, 2012, No. 60. https://www.cdc.gov/nchs/data/nhsr/nhsr060.pdf. Accessed 10 Sept 2019.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Stumbar, S.E., Garba, N.A., Bhoite, P. et al. Pilot Study of a Free Long-Acting Reversible Contraception Program on a Mobile Health Center in Miami Dade County, Florida. J Immigrant Minority Health 22, 421–425 (2020). https://doi.org/10.1007/s10903-019-00937-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10903-019-00937-y