Integrating reproductive planning with primary health care: an exploration among low-income, minority women and men.
BACKGROUND
Despite recommendations to integrate reproductive and preconception health care services with primary health care, integration of such services is uncommon. The purpose of this study was to explore the acceptability and utility of integrating an assessment of reproductive plans into primary care encounters.


METHODS
Using a purposive sampling strategy, we purposively selected 144 African-American and Hispanic females and males from publicly-funded clinics. We assessed their desire for a child and contraceptive practices via a reproductive plans questionnaire. Patients' written responses were attached to the medical record for provider use. After the encounter, we administered semi-structured interviews to elicit patients' opinions about the questionnaire. We audio-recorded and transcribed verbatim responses and qualitatively analyzed them by content analysis.


RESULTS
Overall, 58/72 (81%) of females and 30/72 (42%) of males reported the reproductive plans assessment was important to their encounter, with variation in the reason according to reported desire for a child. According to reported contraceptive practices, >45% who reported never wanting a child or not wanting a child for at least one year were 'at-risk for unintended pregnancy.' A substantial proportion of patients reported uncertainty about desiring a child, and a minority of these reported consistent contraception use.


CONCLUSIONS
Questions to assess patients' reproductive plans were viewed as important by the majority of female and a substantial proportion of male primary care patients, and a substantial proportion were at-risk for unintended pregnancy. Primary care practices should consider implementing a reproductive plans assessment to facilitate linkage of patients to appropriate family planning, preconception, and sexually-transmitted infection services.
Department of Family & Preventive Medicine, Emory University School of Medicine, 1256 Briarcliff Road NE, Building A, Suite 238, Atlanta, GA 30322, United States. amlang@emory.edu
Anne Lang
AL
Dunlop
Kristi Maxwell
KM
Logue
Maria Cecilia
MC
Miranda
Divya A
DA
Narayan
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D003268:Contraception Behavior; D005193:Family Planning Services; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011203:Poverty; D016742:Preconception Care; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D011320:Primary Health Care; D012307:Risk Factors; D055815:Young Adult