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Contraceptive Method Use Among a Population-Based Cohort During the South Carolina Choose Well Initiative.

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Statewide contraceptive access initiatives increased long-acting reversible contraception (LARC) and intrauterine device (IUD) use in South Carolina. These findings support such programs for improving reproductive health services.

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Area of Science:

  • Public Health
  • Reproductive Health
  • Health Services Research

Background:

  • Statewide contraceptive access initiatives are crucial for informing health policy and practice.
  • Evaluating the impact of these initiatives is necessary to understand their effectiveness.

Purpose of the Study:

  • To examine changes in contraceptive method use among women of reproductive age in South Carolina.
  • To assess the impact of the Choose Well contraceptive access initiative on contraceptive method uptake.

Main Methods:

  • A cohort study linked baseline survey data (2017-2018) with 3 follow-up surveys (2019-2021) of women in South Carolina and Alabama.
  • Regression-based differences-in-differences methods compared contraceptive use changes between the states.
  • Analysis included 1344 women, comparing use of long-acting reversible contraception (LARC) and intrauterine devices (IUDs).

Main Results:

  • Long-acting reversible contraception (LARC) use significantly increased in South Carolina (17.6% to 21.1%) compared to Alabama (18.0% to 18.1%).
  • Intrauterine device (IUD) use also significantly increased in South Carolina (14.0% to 17.4%) compared to Alabama (13.8% to 15.9%).
  • Adjusted analyses confirmed a significant increase in the odds of LARC and IUD use in South Carolina post-initiative.

Conclusions:

  • The South Carolina Choose Well initiative was associated with increased use of IUDs and LARC.
  • These increases were not observed in the peer state without the initiative.
  • Findings support the role of statewide contraceptive access initiatives in promoting reproductive health services.