Primary care patients' preferences for reproductive health service needs assessment and service availability in New York Federally Qualified Health Centers

Abstract

Objectives: Expanding reproductive health services in primary care could increase access to preconception and contraceptive services. We assessed patients' preferences around wording, frequency and staffing for reproductive health service needs assessment and availability of a range of reproductive health services in primary care.

Study design: We implemented a cross-sectional anonymous survey of adults in the waiting rooms of four Federally Qualified Health Centers (FQHCs) in New York State in 2017. We present descriptive findings on preferences, including preferences among four questions on reproductive health needs assessment, and differences by socio-demographic characteristics.

Results: We had an 89.4% response rate. Of 1,071 respondents, 68.8% self-reported gender as female, 26.5% male and 4.1% transgender/other, while 40.8% self-identified as black non-Hispanic, 32.2% white non-Hispanic, 17.6% Hispanic and 9.4% other. A third had no preferred reproductive health needs assessment question (34.5%), while another third preferred, "Can I help you with any reproductive health services today such as birth control or planning a healthy pregnancy?" (31.5%). Respondents wanted to be asked by a doctor (43.9%) or nurse/medical assistant (21.1%). Females wanted to be asked at every visit (52.9%) more than males (43.9%) and transgender/other individuals (34.1%, p < 0.01). The majority would like to be able to access contraception (59.0%) and sexually transmitted infection (STI) testing (55.4%) at their FQHC.

Conclusions: Most patients supported inclusion of reproductive health discussions and contraception and STI services at these FQHCs. Among those with a preference, patients preferred to be asked about reproductive health service needs rather than pregnancy intentions or desires.

Implications: Primary care settings should consider routine inclusion of reproductive health needs assessments over screening for pregnancy intentions or desires. Primary care settings which do not currently provide contraception and sexually transmitted infection testing should consider making these services available.

Keywords: Pregnancy intentions; Primary care; Reproductive health; Reproductive intentions; Sexual health.