Provider Perspective on Contraception Barriers Among Reproductive-Age Women in North Carolina Public Deposited

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Last Modified
  • February 28, 2019
Creator
  • Lewis, Lindsey
    • Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
Abstract
  • Background: The United States has a high unintended pregnancy rate. Many public health and health care efforts attempt to increase contraceptive access for U.S. women to prevent unintended pregnancy. However, many barriers to contraceptive access exist. A systematic review was performed to examine published literature about contraceptive barriers for underserved, reproductive-age women in the United States. The objective of this study is to build upon published literature to examine barriers to contraception for women specifically in North Carolina.Methods: I identified contraception providers using the NC Medical Board’s list of practicing OBGYN physicians. I contacted providers by telephone and performed telephone interviews about contraception barriers, according to an interview guide. I transcribed and performed thematic analysis of survey data to identify contraceptive barriers. Results: I contacted 35 providers and 3 providers participated (response rate 8.6%), including 2 OBYGN physicians and 1 nurse practitioner. Thematic analysis identified an array of barriers to contraception, including patient financial and logistical barriers (financial cost to patients, insurance status, type of insurance, transportation, language), health system and structural barriers (reimbursement policies, insurance authorization, requirement of multiple clinic visits for IUD/implant insertion, administrative demands on patients and practices, and schedule of health care appointments/services and time constraints), knowledge gap barriers (patient misconceptions and misinformation, provider knowledge/comfort), culture and ideology barriers (patient cultural/religious beliefs, family/friend influence, partner influence, relationship between provider/educator and patient, patient age, personal competing demands), and medical barriers (contraceptive side effects, medical comorbidities).Discussion: Based on provider perspective, there are many barriers to contraception access for women in North Carolina. Examination of barriers and gaps in contraceptive access provides insight for North Carolina women’s health initiatives and health care policy.
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Note
  • Paper type: Research or research design
  • Track: HC&P
Advisor
  • Tolleson-Rinehart, Sue
Reviewer
  • Morse, Jessica
Degree
  • Master of Public Health
Academic concentration
  • Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2018
Language
Deposit record
  • 5a30a1f0-db1b-4c2a-89e8-03e0a114dde4
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