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Implementing SINC (Self-Identified Need for Contraception) screening: A mixed methods case study.

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Summary
This summary is machine-generated.

Adapted Self-Identified Need for Contraception (SINC) screening for all genders was manageable and acceptable, particularly for assigned-male-at-birth (AMAB) patients. This approach normalized contraceptive care and identified unmet needs in primary care settings.

Keywords:
AdolescentsAssigned-Male-at-BirthContraceptionPractice Change ImplementationPrimary CareScreening

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Area of Science:

  • Reproductive Health
  • Primary Care Implementation Science
  • Health Services Research

Background:

  • Routine contraception screening is often limited to assigned-female-at-birth patients.
  • Assigned-male-at-birth (AMAB) individuals lack typical opportunities for contraceptive discussions.
  • Adapting screening tools is crucial for inclusive reproductive healthcare.

Purpose of the Study:

  • To examine the implementation of adapted Self-Identified Need for Contraception (SINC) screening for all genders (ages 12-44) in primary care.
  • To assess screening rates, implementation facilitators/challenges, and acceptability among AMAB patients.
  • To provide actionable guidance for SINC implementation in diverse patient populations.

Main Methods:

  • Mixed-methods case study utilizing electronic health record (EHR) data and staff/patient interviews.
  • Mixed-effects models analyzed screening and need rates by site, sex, age, and language.
  • Convergent design integrated EHR and qualitative interview findings.

Main Results:

  • Screening rates significantly increased over time, reaching 39.0%-79.0% by 15-18 months post-initiation.
  • Screening rates were 56.4% for assigned-female-at-birth and 44.6% for AMAB patients.
  • Staff and AMAB patients found the adapted-SINC screening manageable, acceptable, and beneficial, with patients reporting comfort.

Conclusions:

  • Adapted SINC screening is a manageable and acceptable intervention for all genders in primary care.
  • Implementation strategies should focus on building buy-in, adapting workflows, and setting realistic timelines.
  • This adapted-SINC approach normalized contraceptive care and effectively identified unmet needs, offering valuable insights for organizations.