Feasibility of a Patient-Centered Intervention to Improve Sexual and Reproductive Healthcare for Military Service...

U.S. Active duty Service members (ADSMs) experience barriers to sexual and reproductive healthcare (SRH). Enhancing patient-centered SRH services is essential to empowering ADSMs to achieve their health goals, which may, in turn, contribute to improved military readiness. This study aimed to assess the feasibility and acceptability of a clinician-led group educational intervention developed to improve ADSMs' awareness of availability of SRH services and self-efficacy to access this care, in order to guide future refinement and implementation of this program.

A series of standardized 20-minute, interactive group educational sessions on SRH topics was delivered over a 12 month period to groups of ADSMs at a large military installation. This pretest-posttest study was conducted without a control group to assess feasibility. The primary outcomes were changes in perceived SRH knowledge and intention to seek future SRH, and were evaluated with McNemar's tests. Logistic regression evaluated the influence of demographic characteristics on these changes.

Participants included 1,077 ADSMs (72% male, 89% junior enlisted). Exposure to the intervention was associated with increased awareness of contraceptive options (pre = 81%/post = 96%), available SRH services (pre = 60%/post = 96%), how to obtain emergency contraception (pre = 57%/post = 96%), human immunodeficiency virus (HIV) pre-exposure prevention (pre = 40%/post = 92%), and how to request sexually transmitted infection (STI) screening (pre = 51%/post = 96%), (ps < 0.001). Participants indicated increased intent to schedule an appointment for STI screening (pre = 8%/post = 17%, P < .001) and contraception (female participants pre = 18%/post = 26%, P = .008). Of those who did not agree that they were comfortable discussing SRH with a military clinician on the pre-intervention questionnaire, 77% reported that they were more encouraged to use SRH services on a military base, and 76% reported that they were more comfortable seeking SRH services in a military clinic after the intervention. Logistic regression showed no statistically significant effects of demographic characteristics on responses to the intervention. One-third of participants requested an appointment after the intervention using an appointment request card. Almost all participants (i.e., 87%) reported plans to share the content.

This patient-centered initiative is feasible and acceptable to ADSMs, may be scalable, and has the potential to reduce barriers and empower ADSMs in optimizing their SRH goals.