eprintid: 35596
rev_number: 21
userid: 8307
dir: disk0/00/03/55/96
datestamp: 2019-01-30 18:43:26
lastmod: 2019-01-30 18:43:26
status_changed: 2019-01-30 18:43:26
type: thesis_degree
metadata_visibility: show
contact_email: oliviamstransky@gmail.com
eprint_status: archive
creators_name: Stransky, Olivia
creators_email: ols25@pitt.edu
creators_id: ols25
title: Reducing unintended pregnancies in Pennsylvania: increasing access to long-acting reversible contraceptives in Title X clinics
ispublished: unpub
divisions: sch_gsph_behavioralcommhealthsci
full_text_status: public
keywords: unintended pregnancy, family planning, Pennsylvania, LARC, birth control, contraception, pregnancy
abstract: INTRODUCTION: Long-acting reversible contraceptives (LARCs) can significantly reduce incidence of teen pregnancy and unintended pregnancy and indirectly reducing the rate of abortion, preterm birth, and low birthweight.  A cohort study and two statewide interventions in the United States have demonstrated the impact LARCs have, yet uptake in the United States remains relatively slow, particularly among 15 to 24-year-olds, who have the highest rates of unintended pregnancy.  Access to effective forms of birth control is an issue of public health significance as it is linked to negative maternal and neonatal health outcomes.  One of the causes of low LARC use is that fewer family planning clinics provide them.  The purpose of this work is to examine the reasons why disparities in LARC access persist as well as the ways in which Pennsylvania, and in particular rural communities, could benefit from a statewide initiative to increase LARC access.
METHODOLOGY: Statewide data from the 2017 Family Planning Annual Report was obtained from each of the four organizations responsible for distributing Title X funding in Pennsylvania.  Each organization provided reports on the insurance status and primary birth control method of female patients at Title X clinics in their respective region of the state.
RESULTS: Title X clinics in Pennsylvania primarily serve uninsured and publicly insured individuals as compared to statewide insurance proportions.  Fewer Title X patients in Pennsylvania use LARCs than patients nationwide, and high disparities exist between rural and urban Pennsylvania counties.  The organizations that oversaw Pittsburgh’s two largest cities, Philadelphia and Pittsburgh, had higher rates of LARC use than the organizations that did not include a large urban area.  
CONCLUSION: Findings suggest a disparity in LARC access between urban and rural communities, and a clinic-by-clinic assessment of birth control methods offered is a recommended next step.  As low-income women are at an increased risk of unintended pregnancy, Title X clinics need to be capable of providing patients with the most effective methods of birth control.
date: 2019-01-30
date_type: published
pages: 61
institution: University of Pittsburgh
refereed: TRUE
etdcommittee_type: committee_chair
etdcommittee_type: committee_member
etdcommittee_type: committee_member
etdcommittee_name: Terry, Martha
etdcommittee_name: Hawk, Mary
etdcommittee_name: Jarlenski, Marian
etdcommittee_email: materry@pitt.edu
etdcommittee_email: mary.hawk@pitt.edu
etdcommittee_email: marian.jarlenski@pitt.edu
etd_defense_date: 2018-12-03
etd_approval_date: 2019-01-30
etd_submission_date: 2018-11-26
etd_release_date: 2019-01-30
etd_access_restriction: immediate
etd_patent_pending: FALSE
thesis_type: thesis
degree: MPH
citation:   Stransky, Olivia  (2019) Reducing unintended pregnancies in Pennsylvania: increasing access to long-acting reversible contraceptives in Title X clinics.  Master's Thesis, University of Pittsburgh.    (Unpublished)  
document_url: http://d-scholarship-dev.library.pitt.edu/35596/1/StranskyOlivia_MPHthesis_Dec2018.pdf