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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedEliason EL, A Spishak-Thomas, Steenland MW
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
The purpose of this study was to assess the relationship of the Affordable Care Act (ACA) Medicaid expansion with postpartum contraception use and pregnancy. The researchers found that Medicaid expansion was associated with a 7.0 percentage point increase in postpartum use of the contraceptive implant and intrauterine device LARC, a 3.1 percentage point decrease in short-acting contraception, and a 3.9 percentage point decrease in non-prescription contraceptive use overall. Increases in LARC use were concentrated among non-Hispanic, White, and Black respondents. Medicaid expansion was associated with a decrease in early postpartum pregnancy only among non-Hispanic Black respondents. The researchers concluded that the ACA Medicaid expansion improved postpartum contraceptive access and led to shifts from methods with a lower upfront out-of-pocket cost for people without insurance towards methods with the higher upfront out-of-pocket cost for people without insurance. These changes suggest that Medicaid expansions increased access to the full range of contraceptive methods.
AHRQ-funded; HS027464; HS000011
Citation: Eliason EL, A Spishak-Thomas, Steenland MW .
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
Contraception 2022 Sep;113:42-48. doi: 10.1016/j.contraception.2022.02.012..
Keywords: Sexual Health, Pregnancy, Maternal Care, Women, Medicaid, Access to Care, Policy
Thompson I, Bryant AG, Stuebe AM
Centering the patient in postpartum contraceptive counseling.
This article discusses the timing of postpartum contraceptive counseling and the fact that many health care providers believe prevention of future pregnancies is a priority in the postpartum period and that the inpatient postpartum stay is an ideal time to discuss contraception. However, this belief is not necessarily shared by the birthing parent, and they might be unready to discuss contraceptives, especially for people whose reproduction has been marginalized. The authors state that health care providers must acknowledge this harmful and racist history to change counseling practices actively and thoughtfully to best meet patient needs while simultaneously respecting patient autonomy.
AHRQ-funded; HS027260.
Citation: Thompson I, Bryant AG, Stuebe AM .
Centering the patient in postpartum contraceptive counseling.
Clin Obstet Gynecol 2022 Sep 1;65(3):588-93. doi: 10.1097/grf.0000000000000725..
Keywords: Maternal Care, Pregnancy, Women, Sexual Health
Dude AM, Schueler K, Schumm LP
Preconception care and severe maternal morbidity in the United States.
This study’s objective was to measure the association between preconception care and the odds of severe maternal morbidity among women with Medicaid using a secondary analysis of Medicaid claims using Medicaid Analytic Extract files. Findings showed that contraceptive services in the year before conception and routine exams for women with chronic disease were associated with decreased odds of severe maternal morbidity or death for Medicaid enrollees.
AHRQ-funded; HS027027.
Citation: Dude AM, Schueler K, Schumm LP .
Preconception care and severe maternal morbidity in the United States.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100549. doi: 10.1016/j.ajogmf.2021.100549..
Keywords: Maternal Care, Pregnancy, Women, Labor and Delivery, Sexual Health
Dalton VK, Moniz MH, Bailey MJ
Trends in birth rates after elimination of cost sharing for contraception by the Patient Protection and Affordable Care Act.
Researchers evaluated changes in birth rates by income level among commercially insured women before (2008-2013) and after (2014-2018) the elimination of cost sharing for contraception under the Patient Protection and Affordable Care Act (ACA). The analytic sample included over 4.5 million women enrolled in 47,721 health plans. In this cross-sectional study, the researchers found that the elimination of cost sharing for contraception under the ACA was associated with improvements in contraceptive method prescription fills and a decrease in births among commercially insured women. Women with low income had more precipitous decreases than women with higher income, suggesting that enhanced access to contraception may address well-documented income-related disparities in unintended birth rates.
AHRQ-funded; HS025465; HS023784.
Citation: Dalton VK, Moniz MH, Bailey MJ .
Trends in birth rates after elimination of cost sharing for contraception by the Patient Protection and Affordable Care Act.
JAMA Netw Open 2020 Nov 2;3(11):e2024398. doi: 10.1001/jamanetworkopen.2020.24398..
Keywords: Policy, Health Insurance, Women, Healthcare Costs, Pregnancy, Sexual Health
Birru Talabi M, Clowse MEB, Blalock SJ
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
This qualitative study sought to assess rheumatologists' perspectives, attitudes, and practices regarding family planning counseling and reproductive health care (FPCC). A geographically diverse sample of U.S. rheumatologists were interviewed and the transcripts of the interviews developed into a code book based on their content. Findings showed that rheumatologists feel a sense of responsibility to provide some aspects of FPCC to reproductive-age female patients. However, their own apprehensions about managing complicated pregnancies may negatively influence how they advise patients about pregnancy planning or avoidance. Future work should focus on eliminating barriers and identifying solutions that support rheumatologists' efforts to provide high-quality FPCC to patients.
AHRQ-funded; HS022989.
Citation: Birru Talabi M, Clowse MEB, Blalock SJ .
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
Arthritis Care Res 2020 Mar;72(3):452-58. doi: 10.1002/acr.23872..
Keywords: Arthritis, Pregnancy, Sexual Health, Provider: Physician, Women
Campbell AD, Turok DK, White K
Fertility intentions and perspectives on contraceptive involvement among low-income men aged 25 to 55.
In this study the authors examined the pregnancy-related attitudes and behaviors among men older than 24, who are involved in the majority of pregnancies ending in a birth. Between December 2015 and August 2016, in-depth interviews were conducted with 26 low-income men in Alabama who were aged 25-55, were sexually active and did not want more children. The investigators found that some low-income adult men were uncertain about their pregnancy desires, and many lacked contraceptive knowledge that would help them avoid unwanted pregnancy.
AHRQ-funded; HS013852.
Citation: Campbell AD, Turok DK, White K .
Fertility intentions and perspectives on contraceptive involvement among low-income men aged 25 to 55.
Perspect Sex Reprod Health 2019 Sep;51(3):125-33. doi: 10.1363/psrh.12115..
Keywords: Sexual Health, Low-Income, Men's Health, Pregnancy
Rice WS, Turan B, White K
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
This study investigated the role of unintended pregnancy norms and stigma in contraceptive use among young women in Alabama. A total of 390 women aged 18-24 were surveyed from November 2014 to October 2015 at university and public health clinics. These women were considered at risk for unintended pregnancy and sexually transmitted diseases. Compared to nonusers, users of contraceptives were more likely to be White, nulliparous, from the university and had higher income. Disapproval of unintended pregnancy by close family and friends was associated with greater contraceptive use.
AHRQ-funded; HS013852.
Citation: Rice WS, Turan B, White K .
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
Women Health 2018 Nov-Dec;58(10):1151-66. doi: 10.1080/03630242.2017.1414099.
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Keywords: Sexual Health, Pregnancy, Social Stigma, Women, Young Adults
Upadhya KK, Jalazo ER, Connor KA
AHRQ Author: Mistry KB
Optimizing preconception health among young women: what are we missing?
This study evaluated whether receipt of specific preconception counseling topics differs between teen, young adult, and older mothers. It found that teen mothers were less than half as likely to be counseled about taking folic acid, 4 times more likely to be counseled about vaccines, and twice as likely to be counseled about mental health before pregnancy compared with adult mothers.
AHRQ-authored.
Citation: Upadhya KK, Jalazo ER, Connor KA .
Optimizing preconception health among young women: what are we missing?
J Pediatr Adolesc Gynecol 2016 Oct;29(5):464-6. doi: 10.1016/j.jpag.2016.02.010.
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Keywords: Children/Adolescents, Sexual Health, Maternal Care, Pregnancy, Women, Young Adults
Morales-Aleman MM, Scarinci IC
Correlates and predictors of sexual health among adolescent Latinas in the United States: a systematic review of the literature, 2004-2015.
The authors conducted a systematic literature review to better understand the correlates and predictors of sexual health among adolescent Latinas in the US. They found that results varied widely between studies, suggesting that the relationship between individual and proximal contextual variables and sexual health may be more complex than previously thought. They concluded that their review integrates the findings on correlates and predictors of sexual health among adolescent Latinas, and supports the need for strengths-based theoretically guided research on the mechanisms driving these associations.
AHRQ-funded; HS013852.
Citation: Morales-Aleman MM, Scarinci IC .
Correlates and predictors of sexual health among adolescent Latinas in the United States: a systematic review of the literature, 2004-2015.
Prev Med 2016 Jun;87:183-93. doi: 10.1016/j.ypmed.2016.03.005.
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Keywords: Children/Adolescents, Racial and Ethnic Minorities, Pregnancy, Racial and Ethnic Minorities, Sexual Health
Upadhya KK, Burke AE, Marcell AV
AHRQ Author: Mistry K
Contraceptive service needs of women with young children presenting for pediatric care.
The primary objective of this study was to characterize the need for contraceptive services and contraceptive method use among women with young children presenting to child health clinics. It found that most women presenting with young children for pediatric care indicated that they were not currently trying to become pregnant and reported current methods of pregnancy prevention that ranged from none to highly effective.
AHRQ-authored.
Citation: Upadhya KK, Burke AE, Marcell AV .
Contraceptive service needs of women with young children presenting for pediatric care.
Contraception 2015 Nov;92(5):508-12. doi: 10.1016/j.contraception.2015.07.004..
Keywords: Pregnancy, Women, Sexual Health
Cha S, Chapman DA, Wan W
Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling.
The objective of the study was to examine the extent to which intimate partner violence (IPV) around the time of pregnancy is associated with postpartum contraceptive use among women in the United States. Approximately 6.2 percent of women reported IPV, and 15.5 percent reported no postpartum contraceptive use. Regardless of the timing of abuse, IPV-exposed women were significantly less likely to report contraceptive use after delivery.
AHRQ-funded; HS023724.
Citation: Cha S, Chapman DA, Wan W .
Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling.
Contraception 2015 Sep;92(3):268-75. doi: 10.1016/j.contraception.2015.04.009..
Keywords: Domestic Violence, Sexual Health, Women, Pregnancy