Demand for abortion training and technical assistance in primary care: Unmet need and programmatic interventions.

Objective: Quantify primary care provider requests for abortion training and technical assistance (TA) and availability of programs to support abortion provision.

Study Design: We reviewed requests for training and TA from four programs focused on capacity building for abortion care. Collectively, these programs serve every region of the United States.

Telehealth Medication Abortion in Primary Care: A Comparison to Usual in-Clinic Care.

Introduction: Providing abortion in primary care expands access and alleviates delays. The 2020 COVID-19 public health emergency (PHE) led to the expansion of telehealth, including medication abortion (MAB). This study evaluates the accessibility of novel telehealth MAB (teleMAB) initiated during the PHE, with the lifting of mifepristone restrictions, compared with traditional in-clinic MAB offered before the PHE at a Massachusetts safety-net primary care organization.

Organizing Primary Care Clinicians to Expand Reproductive Health Access: A Qualitative Program Evaluation.

Background And Objectives: Comprehensive sexual reproductive health care (SRH) in the United States, including abortion, is siloed from primary care, making it more difficult to access. The crisis in access has drastically worsened following the overturning of Roe v Wade, 410 US 113 (1973). Primary care clinicians (PCC) are well-positioned to protect and expand SRH access but do not receive sufficient training or support.

Telemedicine Abortion in Primary Care: An Exploration of Patient Experiences.

Purpose: The purpose of the study was to explore patients' experiences and perspectives obtaining telemedicine medication abortion (TeleMAB) through their primary care health system.

Methods: We conducted in-depth telephone interviews with 14 English-, Spanish-, and/or Portuguese-speaking patients who received a TeleMAB between July 2020 and December 2021, within a large primary care safety-net community health system in Massachusetts. We created and piloted a semistructured interview guide informed by patient-clinician communication frameworks and prior studies on patient experiences with TeleMAB.

Patient perspectives of using reproductive autonomy to measure quality of care: a qualitative study.

Background: Current measures of reproductive health care quality, such as rates of "unintended" pregnancies, neglect to incorporate patients' desires and center their reproductive autonomy. This study explores patients' perspectives on and receptivity to alternative metrics for measuring quality of such care.

Methods: An online research recruitment firm identified eligible participants living in New York, ages 18-45, self-identifying as women, and having visited a primary care provider in the last year.

Implications of Overturning Roe v Wade on Abortion Training in US Family Medicine Residency Programs.

In June 2022, the US Supreme Court overturned , opening the door to state-level abortion bans. By August 2023, 17 states banned abortion or instituted early gestational age bans. We performed an analysis to assess the proportion of accredited US family medicine residency programs and trainees in states with abortion restrictions.

Women's Perspectives on a Reproductive Health Services Screening Question: An Alternative to Pregnancy Intention Screening.

Background: Current efforts to integrate reproductive health care into primary care in the United States involve assessing pregnancy intentions and reproductive goals, which are often not meaningful or attainable for some. Alternatively, we designed a reproductive health services-based screening question: "Can I help you with any reproductive health services today, such as preventing pregnancy or planning a healthy pregnancy?" In this study, we describe women's interpretations of this question as part of a larger study, exploring perspectives on reproductive health care quality in primary care.

Materials And Methods: We utilized a third-party research firm to recruit New York women of reproductive age (18-45), who visited a primary care provider in the past year.

US clinicians' perspectives on how mifepristone regulations affect access to medication abortion and early pregnancy loss care in primary care.

Objective: Protocols including mifepristone are the most effective medication regimens for medication abortion and early pregnancy loss (EPL) management. Both can be safely and effectively offered in primary care settings. Despite mifepristone's excellent safety record, the United States (US) Food and Drug Administration (FDA) heavily regulates provision.

Provision of Early Pregnancy Loss Care in New York Federally Qualified Health Centers.

Background: Office-based early pregnancy loss (EPL) care is safe and suitable to Federally Qualified Health Centers (FQHCs); prevalence of provision in FQHCs is unknown.

Methods: We conducted a mailed site-level survey of FQHCs in New York State (n = 405). Sites that offered prenatal care were eligible for analysis.

Barriers and Enablers to Family Physicians' Provision of Early Pregnancy Loss Management in the United States.

Background: Early pregnancy loss (EPL) is a common experience. Treatment options include expectant management, medication, and uterine aspiration. Although family physicians can offer comprehensive EPL treatment in their office-based settings, few actually do.

Building Community Capacity for Qualitative Research to Improve Pregnancy Intention Screening.

Background: Community-based participatory research (CBPR), with an emphasis on co-learning and collaboration, holds promise for exploring the pregnancy intention (PI) screening needs of Latina patients and their health care providers. We describe a CBPR partnership exploring PI screening processes at a federally qualified health center in New York City, and lessons learned related to community participation, training, and collaboration between partners.

Methods: Stakeholders convened a community advisory board (CAB) to carry out CBPR.

Effectiveness of clinical decision support to enhance delivery of family planning services in primary care settings.

Purpose: There is a need to improve delivery of family planning services, including preconception and contraception services, in primary care. We assessed whether a clinician-facing clinical decision support implemented in a family medicine staffed primary care network improved provision of family planning services for reproductive-aged female patients, and differed in effect for certain patients or clinical settings.

Methods: We conducted a pragmatic study with difference-in-differences design to estimate, at the visit-level, the clinical decision support's effect on documenting the provision of family planning services 52 weeks prior to and after implementation.

"If You Don't Ask, I'm Not Going to Tell You": Using Community-Based Participatory Research to Inform Pregnancy Intention Screening Processes for Black and Latina Women in Primary Care.

Background: Public health and medical professional organizations recommend screening women of reproductive age for pregnancy intention (PI) routinely in primary care. Existing PI screening tools may not address the complexity of intentions for women of color or lower socioeconomic status or be well-suited to primary care settings. This study sought to inform recommendations for carrying out PI screening meaningfully in primary care settings.

Primary care providers' responses to pregnancy intention screening challenges: community-based participatory research at an urban community health centre.

Background: Incorporating pregnancy intention screening into primary care to address unmet preconception and contraception needs may improve delivery of family planning services. A notable research gap exists regarding providers' experiences conducting this screening in primary care.

Objective: To explore primary care providers' perceived challenges in conducting pregnancy intention screening with women of reproductive age and to identify strategies to discuss this in primary care settings.

Intention to provide abortion upon completing family medicine residency and subsequent abortion provision: a 5-year follow-up survey.

Objective: Among family physicians who graduated from residencies with abortion training, we explore the association between intention to provide abortion at the end of residency and abortion provision 5 years postresidency.

Study Design: We invited 2009-2012 graduates from US family medicine residency programs with a required opt-out abortion training rotation or elective abortion training opportunities, and who had completed a baseline end-of-residency survey (N=477) to take our follow-up survey 5 years postresidency (2014-2017). We used logistic regression to examine the association between intention to provide abortion postresidency and abortion provision 5 years later.