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We aim to develop and formatively evaluate a brief social needs screening tool that adheres to Massachusetts Department of Public Health (MDPH) clinical service standards for sexual and reproductive health (SRH) agencies and is acceptable and feasible for use by staff during a clinical encounter. Through a multi-stage literature and expert review process, we developed an evidence-informed, two-page social needs screening tool, scoring form, and implementation guide. We piloted this tool at three SRH agencies in Massachusetts and recruited staff to provide quantitative and qualitative feedback through post-pilot test self-reported surveys and semi-structured interviews. Participants (n = 13) felt the social needs screening tool was easy to integrate into their clinical workflow and were comfortable using it with patients. All participants reported feeling comfortable administering the tool, scoring it, and referring patients to appropriate resources, if applicable. Most reported they would like to continue using the tool after the pilot implementation period, either with or without modifications. Our multi-stage tool development and formative evaluation process involving literature review, expert review, and pilot-testing in clinical settings enabled our team to create a brief, evidence-informed social needs screening tool that is acceptable to staff and feasible for use during a short clinic visit at SRH agencies in Massachusetts. Staff felt that there is value in using this tool, are comfortable using it, and are able to integrate it into their existing clinical workflows.

Objectives: We aimed to develop and evaluate a novel model, PHI CARE, that provides a standardized framework for shared decision-making in contraceptive counseling., Methods: We developed the PHI CARE model with national experts, piloted it at three family planning clinics, and finalized it following additional patient and clinician review. We recruited pregnancy-capable people for an evaluation study via simulated contraceptive counseling and identified salient themes through inductive and deductive coding., Results: Participants (n = 12) felt that counseling with the PHI CARE model was an improvement over previous counseling experiences and led to feelings of empowerment; participants did not feel pressured to decide about method use, felt in control during the conversation, and appreciated the absence of assumptions about their desires around pregnancy. Despite the standardized format, participants felt the counseling was individualized, "values-based," and tailored to their preferences., Conclusion: PHI CARE is a model to support clinicians and counselors in operationalizing the principles of shared decision-making in contraceptive counseling. Through standardization, PHI CARE allows for a more individualized experience for patients and addresses many critiques of traditional counseling., Practice Implications: PHI CARE is a memorable, brief tool that can be used for patient-centered contraceptive counseling in any clinical encounter., (Copyright © 2024 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.)

Background: Postpartum contraceptive use can help prevent short-interval pregnancies, which have been associated with adverse neonatal and maternal health outcomes. Many contraceptive methods are safe for postpartum use, but patients and providers may be confused as to what impact hormonal contraception has on lactation. We performed a scoping review of the most recent U.S.-based guidelines regarding hormonal contraception on lactation to provide synthesis and recommendations to aid providers in counseling their patients. Methods: We conducted a scoping review by identifying the most recent clinical recommendations and guidelines from the Centers for Disease Control and Prevention (CDC) and three maternal and child health professional associations (American College of Obstetricians and Gynecologists [ACOG], Society for Maternal-Fetal Medicine [SMFM], and Academy of Breastfeeding Medicine [ABM]). We also reviewed the citations in these guidelines used in their development. We then conducted an updated literature review to capture studies published since the most recent systematic reviews were conducted. Results: We reviewed 1 clinical guideline from the CDC and 2 systematic reviews cited in its references, 6 professional association recommendations, and 28 publications identified through the updated literature review. Progestin-only contraceptive methods continue to demonstrate safety in breastfeeding patients, while low-quality evidence supports concerns of decreased milk supply with combined hormonal contraception. Discussion: Organizations should consider updating counseling recommendations regarding progestin-only contraceptives and lactation. Further research is needed to examine new contraceptive methods as well as the effect of hormonal contraception on lactation in the setting of preterm birth.