Evidence map›Paper›PMID 35918666›Full record

ArticleBMC women's health2022

Does access to no-cost contraception change method selection among individuals who report difficulty paying for health-related care?

Alexandra Gero, Rebecca G Simmons, Jessica N Sanders, David K Turok

Registry-linked trialAbstract read
In one paragraph

Article in BMC women's health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02734199 (Highly Effective Reversible Contraceptive Initiative-Salt Lake), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02734199 completednot on this map

Highly Effective Reversible Contraceptive Initiative-Salt Lake (HER-SL)

TypeobservationalSponsorUniversity of UtahRan2014 to 2020Enrolled4,430ConditionsBirth Control, Contraception
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Alexandra GeroDepartment of Obstetrics and Gynecology, University of Utah School of Medicine, 30N 1900E Rm 2B-200, Salt Lake City, UT, 84132, USA. alexandra.gero@hsc.utah.edu.
Rebecca G SimmonsDepartment of Obstetrics and Gynecology, University of Utah School of Medicine, 30N 1900E Rm 2B-200, Salt Lake City, UT, 84132, USA.
Jessica N SandersDepartment of Obstetrics and Gynecology, University of Utah School of Medicine, 30N 1900E Rm 2B-200, Salt Lake City, UT, 84132, USA.
David K TurokDepartment of Obstetrics and Gynecology, University of Utah School of Medicine, 30N 1900E Rm 2B-200, Salt Lake City, UT, 84132, USA.

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
UNIVERSITY OF UTAH CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE-UL1: BPCAUL1RR025764 · NCRR · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2008 to 2011
$19.4M
University of Utah Center for Clinical and Translational Science-UL1UL1TR000105 · NCATS · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2012 to 2013
$5.1M
Utah Women's Reproductive Health Research Career Development ProgramK12HD085816 · NICHD · UNIVERSITY OF UTAH · PI SILVER, ROBERT M. · 2015 to 2024
$3.2M
Utah Building Interdisciplinary Resreach Careers in Women's Health Career Development ProgramK12HD085852 · NICHD · UNIVERSITY OF UTAH · PI VARNER, MICHAEL W. · 2015 to 2019
$2.3M
Midcareer Investigator Award in Patient-Oriented Research K24K24HD087436 · NICHD · UNIVERSITY OF UTAH · PI TUROK, DAVID · 2017 to 2021
$942k
AHRQ HHS K01 HS027220NCATS NIH HHS UL1 TR000105NCATS NIH HHS UL1 TR002538NCRR NIH HHS UL1 RR025764NICHD NIH HHS K12 HD085816NICHD NIH HHS K12 HD085852NICHD NIH HHS K24 HD087436
6 · The paper itself

Abstract

backgroundOut-of-pocket costs continue to be a barrier to accessing necessary healthcare services, including contraception. We explored how eliminating out-of-pocket cost affects contraceptive method choice among people reporting difficulty paying for healthcare in the previous year, and whether method satisfaction differed by method choice.

methodsWe used data from the HER Salt Lake Contraceptive Initiative. This prospective cohort study provided participants with no-cost contraception (April 2016-March 2017) following a control period that provided no reduction in cost for the contraceptive implant, a reduced price for the hormonal IUD, and a sliding scale that decreased to no-cost for the copper IUD (September 2015-March 2016). We restricted the study population to those who reported difficulty paying for healthcare in the past 12 months. For our primary outcome assessing changes in method selection between intervention and control periods, we ran simultaneous multivariable logistic regression models for each method, applying test corrections for multiple comparisons. Among participants who continued their method for 1 year, we explored differences in method satisfaction using multivariable logistic regression.

resultsOf the 1,029 participants reporting difficulty paying for healthcare and controlling for other factors, participants more frequently selected the implant (aOR 6.0, 95% CI 2.7, 13.2) and the hormonal IUD (aOR 3.2, 95% CI 1.7, 5.9) during the intervention than control period. Comparing the same periods, participants less frequently chose the injection (aOR 0.5, 95% CI 0.3, 0.8) and the pill (aOR 0.4, 95% CI 0.3, 0.6). We did not observe a difference in uptake of the copper IUD (aOR 2.0, 95% CI 1.0, 4.1).Contraceptive satisfaction scores differed minimally by contraceptive method used among contraceptive continuers (n = 534). Those who selected LNG IUDs were less likely to report low satisfaction with their method (aOR 0.5, 95% CI 0.3, 0.97).

conclusionWith costs removed, participants who reported difficulty paying for healthcare were more likely to select hormonal IUDs and implants and less likely to select the injectable or contraceptive pills. Among continuers, there were few differences in method satisfaction. CLINICALTRIALS: gov Identifier NCT02734199.

Indexed as

Contraceptive Agents, FemaleIntrauterine Devices, CopperContraceptionContraceptive AgentsDelivery of Health CareFemaleHumansProspective StudiesContraceptive AgentsContraceptive Agents, FemaleContraceptionHealthcareLow-costPoverty

Identifiers

PMID35918666
PMCPMC9344653

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.