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BackgroundAccess to high-quality, comprehensive contraceptive care is an inherent component of reproductive human rights. However, hindrances to specific aspects of contraceptive provision, including availability, accessibility, acceptability, and quality, continue to perpetuate unmet needs. The state of Utah has recently passed a series of contraceptive policies intended to improve contraceptive access. Despite these positive changes to theoretical access, fiscal appropriations to support the implementation of these policies have been minimal, and many individuals still struggle to access contraception. ObjectiveThe Family Planning Elevated Contraceptive Access Program (FPE CAP), part of a larger statewide contraceptive initiative, specifically aims to improve contraceptive access within health clinics. This paper describes the study protocol for evaluating the success of FPE CAP. MethodsHealth clinics apply for membership in the FPE CAP. On acceptance in the program, they receive a cash grant for clinical supplies, equipment, and personnel expenses; reimbursement for contraceptive services and methods for eligible clients; technical support, training, and proctoring on counseling and providing all methods of contraception; method stocking of intrauterine devices and implants; and demand generation activities, including local media campaigns, to inform community members about the FPE CAP and possible eligibility. FPE collects monthly service delivery reports from participating clinics for evaluation purposes. The primary outcomes of FPE CAP are level and trend changes in contraceptive service delivery among individuals earning ≤138% federal poverty level (FPL) following membership in FPE CAP and among FPE CAP clients earning between 139% and 250% FPL (including those ineligible for Medicaid) compared with historical data and control clinics. To assess this, we will conduct comparative interrupted time series analyses assessing the level and trend changes in intervention and control clinics 12 months before the intervention, for the 2-year duration of the intervention, and for the subsequent 12 months following the intervention. ResultsWe found that the study is adequately powered (>80% power) with our planned number of clinics and the number of months of data available in the study. To date, we have successfully completed the recruitment and enrollment of 8 of the expected 9 health organizations and 4 of the control clinics. Completed health organization enrollment for both intervention and control organizations is expected to be completed in December 2020. ConclusionsThe study aims to provide insight into a new approach to contraceptive initiatives by addressing comprehensive aspects of contraceptive care at the health system level. Ongoing state policy changes and implementation components may affect the evaluation outcomes. International Registered Report Identifier (IRRID)DERR1-10.2196/18308

Objective: Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged in the USA. Free clinic patients may have health education needs, but experience barriers to attending health education programmes. In an attempt to reach out to free clinic patients who might not otherwise attend health education classes, this project examined the efficacy of student-led health education classes conducted in the waiting room prior to a patient's appointment with a provider. Design: The classes had two areas of focus: women's health and health information. Health educators and Spanish interpreters were graduate and undergraduate students. Setting: This study was conducted in the waiting room of a free clinic in the Intermountain West region of the USA. Method: The health education classes were held 22 times in total from late August to early December 2014. Results: While the survey-based assessment of the programme did not show a difference in levels of health consciousness, health information seeking and health attitudes, the programme potentially increased interest in attending the health education classes. Conclusion: There were some challenges associated with the implementation of a health education class in the waiting room setting, particularly in regards to environments, evaluation and interpretation services. Future projects are needed to address challenges associated with conducting a health education class in a waiting room setting. In addition, a variety of health topics, evidence-based evaluation and interpreter services are key for future success.

Previous studies in India suggest high prevalence of intimate partner violence (IPV), childhood abuse, and abuse from in-laws. Yet few studies examined IPV, childhood abuse, and abuse from in-laws together. The purpose of this study is to examine the association between IPV, childhood abuse, and abuse from in-laws, and types of abuse (physical, sexual, and emotional abuse) among women utilizing community health services for the economically disadvantaged in India. This study contributes to expanding the literature on abuse experience and providing knowledge for developing intervention programs and research projects to improve health and safety of economically disadvantaged women. The data were collected from women aged 18 years old or older at 18 community health centers that are primarily for the economically disadvantaged in Gujarat, India, in October and November 2013. Of the 219 women who completed a self-administered survey, 167 participants, who had ever been married and indicated whether they had been abused by their spouse or not, were included in analysis. More than 60% of the participants experienced IPV, childhood abuse, and/or abuse from in-laws, often with multiple types of abuse. Physical abuse is a major issue for IPV, childhood abuse, and in-law abuse. Emotional abuse potentially happens along with physical and/or sexual abuse. Abuse from in-laws requires greater attention because all types of abuse from in-laws were associated with IPV. Community health centers should provide abuse prevention and intervention programs that have involvement of family members as well as women who are at risk of being abused. [ABSTRACT FROM AUTHOR]