Increasing Access to Reproductive Health Care for Underserved Women: Lessons Learned from Student Advocates [4F

Abstract

INTRODUCTION: The American College of Obstetricians and Gynecologists supports access to comprehensive contraceptive methods for all women. The most effective reversible birth control method is long acting reversible contraception (LARC), which includes intrauterine devices (IUD) and the birth control implant. Although LARC is used by 7.2% of all women ages 15-44 in the United States, access is limited for underserved women. This study evaluates a patient advocacy program for women with barriers to accessing LARC and abortions. METHODS: Senior medical students designed an 8-hour training program to educate first-year Student Reproductive Health Advocates in contraception, counseling, pregnancy options, and legal-financial concerns. Patients were referred to advocates for connection to LARC or abortions. Advocates reported progress with patients biweekly and completed a survey. Three years of data were collected. RESULTS: Over three years, 48 students advocated for a total of 196 patients, and students reported outcomes for 174 patients. Out of the 71% of patients that students successfully contacted, 37% were lost to follow up after counseling. Advocates made appointments for the remaining 34% of patients, out of which 58% received the service they requested (LARC or abortion). Students cited insurance restrictions, patient loss of interest in LARC, and LARC availability as barriers in 36% of the patients. Patients who had any of these barriers were less likely to receive LARC (p < 0.05). CONCLUSION: Student-reported patient outcomes revealed aspects of success and areas of improvement for the program. Overall, student advocates have the potential to positively impact women’s access to reproductive healthcare.