Study protocol: ACCESS: (Advancing Contraceptive Equity and Service Uptake through Telemedicine in the US Safety-Net)

Area of Science:

• Reproductive Health
• Health Services Research
• Telemedicine

Background:

• Access to desired contraceptive care is vital for reproductive autonomy.
• Community-based health centers are key in providing family planning services.
• The role and equity of telemedicine in contraceptive care within the US safety net are not well understood.

Purpose of the Study:

• To examine telemedicine use for contraceptive services in US community-based health centers.
• To identify patient populations utilizing telemedicine for contraception.
• To assess inequities and unintended consequences of telemedicine versus in-person contraceptive care.

Main Methods:

• A 5-year, mixed-methods study across over 2400 US community health centers.
• Quantitative analysis of electronic health records (ADVANCE network) to assess telemedicine use, inequities, and outcomes.
• Qualitative investigation into patient and provider experiences with telemedicine for contraceptive care.

Main Results:

• Analysis of telemedicine versus in-person visits for contraceptive care.
• Quantification of inequities in access and utilization of telemedicine for contraception.
• Evaluation of impacts on contraceptive method switching, no-show rates, and LARC access.

Conclusions:

• The study will provide real-world evidence on telemedicine for contraceptive services in the US safety net.
• Findings will inform best practices for telemedicine delivery and policy decisions.
• Results aim to reduce disparities in contraceptive care access and enhance reproductive autonomy.