Contraceptive utilization at publicly funded clinics before and after introduction of low-cost levonorgestrel intrauterine system: a retrospective case study analysis.

Cost can be a barrier to accessing safe and affordable contraception. Therefore, we sought to understand how the availability and utilization of a low-cost levonorgestrel intrauterine system (hormonal IUD) impacts uptake relative to other contraceptive methods. Another objective was to determine if the percentage of self-pay women who obtained a hormonal IUD changed over time. Electronic health record (EHR) data was collected from five public health organizations enrolled in the 340B drug-pricing program (30 individual health centers) from April 15, 2014, through December 31, 2017, with most sites receiving Title X funding. The study captured data before and after low-cost hormonal IUD introduction. Interview data from 28 key informants provided a deeper understanding of how trends in hormonal IUD use changed after low-cost hormonal IUD introduction. Encounters from 101,075 women were analyzed. Locally weighted scatterplot smoothing (LOWESS) trends revealed an increasing utilization for all long-acting reversible contraception (LARC) and a decreasing trend for short-acting methods. Among self-pay women, hormonal IUD uptake increased 3 percentage points (p < .001) after the introduction of low-cost hormonal IUD. Privately insured women saw a 7-percentage point increase in hormonal IUD uptake while women whose family income was greater than 200% of the federal poverty level (FPL) saw a 13.9 percentage point increase in hormonal IUD uptake. The introduction of a low-cost hormonal IUD was associated with more self-pay and low-income women accessing this method. Access to and utilization of low-cost hormonal IUDs are complicated by many factors including product availability and provider training.

Body Appreciation and Discontinuing Contraceptive Use Due to Concern About Weight Gain: A Brief Report.

Objective: This study explored the relationship between body appreciation and discontinuing contraception due to concern about weight gain. Methods: A racially and ethnically diverse sample of women, from the United States, (n = 494) was recruited online. Binomial logistic regression was used for analysis. Results: Participants with higher body appreciation were less likely to stop taking birth control due to concern about weight gain (OR = 0.56, p = .002). These results suggest body appreciation may be a defense against concern about weight gain associated with contraceptive use. Conclusions: Interventions aimed at increasing women's body appreciation, body positivity, as well as decreasing weight stigma could improve contraception use.

Exploring Body Image, Contraceptive Use, and Sexual Health Outcomes Among an Ethnically Diverse Sample of Women.

This cross-sectional study examined the links between body appreciation, contraceptive use, and sexual health outcomes. Body appreciation has been shown to influence contraceptive use in homogenous samples of women. However, a common problem in body image literature is a lack of racial and ethnic diversity with regard to sample; this study was able to take steps toward overcoming that limitation. A sample of 499 women aged 18-56 (M = 26.24; SD = 6.15) was recruited via Reddit.com-White (29.3%, n = 120), Asian (19%, n = 78), Black (17.3%, n = 73), multiracial (13.9%, n = 57), and Latina (13.9%, n = 57). Covariates included race/ethnicity, body size as measured by body mass index, relationship status, age, sexual orientation, and education level. Results indicated that higher levels of body appreciation were related to a higher likelihood of using non-barrier contraception. Regarding the covariates, race, relationship status, age, and education were related to non-barrier contraceptive use and age was related to dual contraceptive use. Further exploration is needed to determine how body appreciation may affect contraceptive use and sexual health outcomes and how these differ by race/ethnicity.

Communication about childhood obesity on Twitter.

OBJECTIVES: Little is known about the use of social media as a tool for health communication. We used a mixed-methods design to examine communication about childhood obesity on Twitter. METHODS: NodeXL was used to collect tweets sent in June 2013 containing the hashtag #childhoodobesity. Tweets were coded for content; tweeters were classified by sector and health focus. Data were also collected on the network of follower connections among the tweeters. We used descriptive statistics and exponential random graph modeling to examine tweet content, characteristics of tweeters, and the composition and structure of the network of connections facilitating communication among tweeters. RESULTS: We collected 1110 tweets originating from 576 unique Twitter users. More individuals (65.6%) than organizations (32.9%) tweeted. More tweets focused on individual behavior than environment or policy. Few government and educational tweeters were in the network, but they were more likely than private individuals to be followed by others. CONCLUSIONS: There is an opportunity to better disseminate evidence-based information to a broad audience through Twitter by increasing the presence of credible sources in the #childhoodobesity conversation and focusing the content of tweets on scientific evidence.