Change in Contraceptive Use Within South Carolina Medicaid Following the Choose Well Contraceptive Access Initiative: Did COVID-19 Alter the Trends?

Objectives: COVID-19 hit at the midpoint of Choose Well, a statewide contraceptive access initiative commenced in South Carolina (SC) in 2017. This study assessed whether the pandemic altered the trends in contraceptive use among SC Medicaid during the first half of Choose Well.

Methods: Contraception use among 333,253 women was analyzed from 2017 to 2022, divided into (January 2017-February 2020) and (March 2020-December 2022) periods.

Postpartum Insurance Loss: Predicting Factors, Associations with Postpartum Health Service Utilization, and the Role of Medicaid Expansion.

Objectives: This study investigated the predictors of postpartum insurance loss (PPIL), assessed its association with postpartum healthcare receipt, and explored the potential buffering role of Medicaid expansion.

Methods: Data from the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed, covering 197,820 individuals with live births. PPIL was determined via self-reported insurance status before and after pregnancy.

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

Importance: Evaluating the impact of statewide contraceptive access initiatives is necessary for informing health policy and practice.

Objective: To examine changes in contraceptive method use among a cohort of women of reproductive age in South Carolina during the Choose Well contraceptive access initiative.

Design, Setting, And Participants: In this cohort study, baseline data from the initial Statewide Survey of Women administered from October 1, 2017, to April 30, 2018, to a probability-based sample of women of reproductive age in South Carolina and a peer state (Alabama) were linked with 3 follow-up surveys given in 2019, 2020, and 2021.

A qualitative inquiry to explore management of distal radius fracture by certified hand therapists.

Background: Distal radius fractures (DRF) are extremely common in middle-aged and elderly. Certified Hand Therapists (CHT) are experts in managing hand injuries including DRF.

Purpose: Using qualitative methodology, this study examined practice patterns among CHT and understand prevalent common patterns in managing DRF.

Contraceptive counseling, method satisfaction, and planned method continuation among women in the U.S. southeast.

Objectives: We used the validated Person-Centered Contraceptive Counseling (PCCC) scale to examine experiences with counseling and associations between counseling quality, method satisfaction, and planned method continuation at the population level in two southeastern states.

Study Design: We used data from the Statewide Survey of Women, a probability-based sample of reproductive-aged women in Alabama and South Carolina in 2017/18. We included women using a contraceptive method and reporting a contraceptive visit in the past year (n = 1265).

Community Engagement in Behavioral Medicine: A Scoping Review.

Background: Behavioral medicine has made key contributions toward improving health outcomes. Engaging community partners in research is critical to addressing persistent health inequities. The aim of this scoping review was to explore how researchers engaged community partners within the field of behavioral medicine research from 2005 to 2023.

Impact of the Choose Well Contraceptive Access Initiative on Method Use Among Women Enrolled in South Carolina's Medicaid Program: A Mid-line Assessment.

Introduction: A six-year statewide contraceptive access initiative focused on equitable access to contraception, removing cost barriers, capacity building and training, raising consumer awareness, and expanding contraceptive care at safety net clinics was implemented in South Carolina beginning in 2017. This study assessed changes in contraceptive method use among women enrolled in the South Carolina Medicaid program during the first three years of Choose Well.

Methods: Contraception use among a retrospective cohort of women aged 15 to 45 enrolled in South Carolina Medicaid from 2012 to 2020 was examined.

Association of Health Insurance with Contraceptive Use and Interpersonal Quality of Contraceptive Care in the Southeast United States.

Objectives: Health insurance remains an important dimension of contraceptive access. This study investigated the role of insurance in contraceptive use, access, and quality in South Carolina and Alabama.

Methods: The study used a cross-sectional statewide representative survey that assessed reproductive health experiences and contraceptive use among reproductive-age women in South Carolina and Alabama.

Contraception Use and Pregnancy Outcomes for Alabama Medicaid Enrollees: A Baseline Analysis Using 2012-2017 Data.

Objectives: Access to the full range of contraceptive methods, including long-acting reversible contraception (LARC), is key for preventing unintended pregnancies and improving health outcomes. In 2019, Alabama Medicaid started paying for LARC devices for postpartum women. In anticipation of evaluating the impact of this programmatic change, we conducted a baseline study exploring contraception use and pregnancy-end outcomes for enrollees before the change.

Contraceptive care service provision via telehealth early in the COVID-19 pandemic at rural and urban federally qualified health centers in 2 southeastern states.

Purpose: To investigate telehealth use for contraceptive service provision among rural and urban federally qualified health centers (FQHCs) in Alabama (AL) and South Carolina (SC) during the initial months of the COVID-19 pandemic.

Methods: This is a mixed-methods study using data from the FQHC Contraceptive Care Survey and key informant interviews with FQHC staff in AL and SC conducted in 2020. Differences between rural and urban clinics in telehealth use for contraceptive service provision were assessed with a chi-square test of independence.

Medicaid Cost Savings from Provision of Contraception to Beneficiaries in South Carolina, 2012-2018.

This study assesses cost savings associated with specific contraceptive methods provided to beneficiaries enrolled in South Carolina Medicaid between 2012 and 2018. Incremental cost-effectiveness ratios, defined as the additional cost of contraception provision per live birth averted, were estimated for 4 contraceptive methods (intrauterine devices [IUDs], implants, injectable contraceptives, and pills), relative to no prescription method provision, and savings per dollar spent on method provision were calculated. Costs associated with publicly funded live births were derived from published sources.

Telehealth for Contraceptive Care During the Initial Months of the COVID-19 Pandemic at Local Health Departments in 2 US States: A Mixed-Methods Approach.

Objectives: This study examined implementation of telehealth for contraceptive care among health departments (HDs) in 2 Southern US states with centralized/largely centralized governance structures during the early phase of the COVID-19 pandemic. Sustaining access to contraceptive care for underserved communities during public health emergencies is critical. Identifying facilitators and barriers to adaptive service provision helps inform state-level decision making and has implications for public health policy and practice, particularly in states with centralized HD governance.

Contraceptive Access at Federally Qualified Health Centers During the South Carolina Choose Well Initiative: A Qualitative Analysis of Staff Perceptions and Experiences.

Federally qualified health centers (FQHCs) provide essential contraceptive services to low-income individuals; yet, access to all method options, notably intrauterine devices (IUDs) and implants, may be limited at non-Title X FQHCs. The South Carolina (SC) Choose Well initiative is a statewide contraceptive access initiative that was launched in 2017 and extends into 2022. Choose Well established a collaborative network between training and clinical partners and is aimed at facilitating implementation of contraceptive care best practices through capacity-building and training of clinical and administrative staff in partner organizations.

Accessibility of federally funded family planning services in South Carolina and Alabama.

This study operationalized the five dimensions of health care access in the context of contraceptive service provision and used this framework to examine access to contraceptive care at health department (HD) (Title X funded) and federally qualified health center (FQHC) (primarily non-Title X funded) clinics in South Carolina and Alabama. A cross-sectional survey was conducted in 2017/18 that assessed clinic-level characteristics, policies, and practices related to contraceptive provision. Provision of different contraceptive methods was examined between clinic types.

Adolescent Birth Rates and Rural-Urban Differences by Levels of Deprivation and Health Professional Shortage Areas in the United States, 2017-2018.

To examine the differences in adolescent birth rates by deprivation and Health Professional Shortage Areas (HPSAs) in rural and urban counties of the United States in 2017 and 2018. We analyzed available data on birth rates for females aged 15 to 19 years in the United States using the restricted-use natality files from the National Center for Health Statistics, American Community Survey 5-year population estimates, and the Area Health Resources Files. Rural counties had an additional 7.