A Step Ahead Foundation (ASAF) was established in 2011 to provide free, long-acting, reversible contraception (LARC) to women in Memphis and Shelby County in an effort to prevent unplanned pregnancy, and allow women to plan when and how they choose to have families. This report provides an overview of the data collected from the first year of the program. During the first year, ASAF has made significant progress toward their two primary outcome goals.
The first goal of ASAF was to increase community outreach related to LARC. In their startup year, ASAF made considerable effort to raise awareness of the effectiveness of LARC and the availability of LARC through their program.
ASAF developed and disseminated marketing materials via health fairs, the internet (e.g., Facebook, Twitter, ASAF website), radio and television advertisements, articles in local publications, and appearances on local broadcasts. 60,000 card flyers were distributed, 50,000 of which were in both English and Spanish.
ASAF established a call center, which provided information on where to obtain LARC, scheduled appointments, and arranged transportation to and from clinics. During the first year, the call center received 2,210 telephone calls.
ASAF established partnerships with the Memphis Health Center(MHC) and 6 Christ Community Health Services (CCHS) clinics to recruit women and provide LARC, with ASAF acting as the payer of last resort.
In the first year, 1,057 women completed consent forms indicating intent to obtain LARC or information about LARC. Most were either uninsured (67%) or received TennCare (21%), and over two thirds of the women had experienced at least one prior pregnancy. The largest numbers of women who completed the consent process were from the zip codes 38118 (n=107) and 38115 (n=104), areas with high numbers of births in Shelby County.
ASAF provided training to healthcare providers, which expanded LARC access at the MHC and 6 CCHS locations.
In the first year, 431 women received LARC paid in full by ASAF, the payer of last resort. These included Depo-Provera shots (31%), Mirena and ParaGard IUDs (36%), and Implanon/Nexplanon (14%). In addition, ASAF paid 76 co-pays for women who eventually received LARC paid for by Title X, TennCare, and private insurance.
Services included “well women” checks, prevention, and procedures related to providing LARC. The average number of appointments per client was 1.65, and the average cost per patient for all services was $343.55.
The vast majority of recipients were either uninsured (72%) or received TennCare (18%), and over 75% of the women who received LARC with ASAF as the payer of last resort had already experienced at least one pregnancy, indicating significant need among the women served.
Increase outreach efforts in areas with high birth rates, including the following zip codes: 38127, 38128, 38134, 38016, 38114, 38106, 38125, and 38122.
Add health care provider partners in areas with high birth rates that are not already served by existing partners: 38128, 38134, 38106, 38016, 38018, and 38125.
Increase outreach efforts to men, as they have the opportunity to share and influence their partners’ decisions regarding the type of contraception used. Target areas that men frequent, such as barber shops.
Increase outreach through faith-based partners, including building on faith-based partners active in Memphis Teen Vision (MemTV).
Expand outreach efforts to include neighborhood community centers and Women, Infants, and Children (WIC)offices.
Use recent medical studies demonstrating the efficacy of LARC to develop outreach materials that specifically target clinicians and healthcare professionals who share information about contraception with clients. Outreach should also target healthcare facility administrators.
Partner with the pharmaceutical companies that make LARC products to promote them in local clinics.
Produce a new video/advertisement featuring women who have recently received LARC to play in the waiting rooms of ASAF health care provider partners. Messages from real, recent clients may reduce uncertainty and increase favorability toward LARC.
Provide potential patients with information about LARC while in the waiting room before their appointment to allow time to review options and formulate questions before meeting with their health care providers. Also, station an outreach specialist in waiting rooms at high volume times to speak with women about LARC.
Read the entire report here.
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