Expanding Access to Contraception: Identifying Accessibility Gaps Across Hawai'i Communities.

In 2019, Hawai'i ended its Title X program resulting in a loss of federal family planning funds. Additionally, physician shortages have decreased family planning resources available to patients. The objective of this study was to assess contraception availability by determining the number and location of healthcare providers in Hawai'i that prescribed at least one form of contraception. A list of healthcare providers was compiled using Google searches, major health insurance, and hospital provider directories. Providers were organized by physical location (ie, address). Each location was contacted to inquire about each provider's ability to prescribe different forms of contraception (eg, intrauterine device, implant, injection, pill, patch, or ring). Of the 1,020 locations contacted, 274 prescribed at least one form of contraception. Of the 1,810 providers surveyed at these locations, 744 prescribed at least one form of contraception. In regard to insurance, 201 locations and 609 providers accepted at least one form of Medicaid. Most prescribing providers were located on the island of O'ahu. The majority of providers across the state prescribed the pill, patch, or ring. There are many additional barriers that were not addressed in this study, including factors that affect physician prescribing practices. Identifying these barriers is important to further address gaps in contraceptive accessibility. Consideration of improved support for training in specialties such as Family Medicine, Internal Medicine, and Pediatrics can expand access to contraception within primary care settings.

The Effect of Skinfold on the Assessment of the Mean Power Frequency at the Fatigue Threshold.

The purpose of this study was to determine if the amount of subcutaneous tissue over the quadriceps affects the assessment of mean power frequency at the fatigue threshold (MPFFT). It was hypothesized that greater skinfold values will result in lower power outputs associated to the MPFFT. Fourteen adults (Mean ± SD age = 20.7 ± 0.99; body weight = 72.8 ± 12.6 kg) performed an incremental cycle ergometry test to exhaustion while surface electromyographic (EMG) signals were measured from the vastus lateralis. The skinfold thickness of each leg was taken prior to the test, and skinfold thicknesses were separated into a larger and a smaller groups. The independent t-test showed a significant difference (p = 0.01) between the power outputs associated to the MPFFT of groups with high (Mean ± SD 130.4 ± 34.5 W) versus low skinfold (212.5 ± 61.2 W) values. The results suggested that higher subcutaneous fat may have affected the assessment of MPFFT during cycle ergometry.