Skip to main content

Advertisement

SpringerLink
Log in

Providing General and Preconception Health Care to Low Income Women in Family Planning Settings: Perception of Providers and Clients

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006–2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. D’Angelo, D.,Williams, L., Morrow, B., Cox, S., Harris, N., Harrison, L., Posner, S. F., Hood, J. R., & Zapata, L. (2007). Preconception and interconception health status of women who recently gave birth to a live-born infant—pregnancy risk assessment monitoring system (PRAMS), United States, 26 Reporting Areas, 2004. MMWR 56(SS10), 1–35. http://www.cdc.gov/mmwR/preview/mmwrhtml/ss5610a1.htm#tab2. Accessed 22 Oct 09.

  2. Johnson, K., Posner, S. F., Biermann, J., Cordero, J. F., Atrash, H. K., Parker, C. S., et al. (2006). Recommendations to improve preconception health and health care—United States. MMWR, 55(RR06), 1–23.

    PubMed  Google Scholar 

  3. Moos, M. K., Dunlop, A. L., Jack, B. W., Nelson, L., Coonrod, D. V., Long, R., et al. (2008). Healthier women, healthier reproductive outcomes: Recommendations for routine care for all women of reproductive age. American Journal of Obestrics and Gynecology, 199(6 Suppl 2), S280–S289.

    Article  Google Scholar 

  4. Bloom, B. B., Simpson, G., Cohen, R. A., & Parsons, P. E. (1997). Access to health care, Part 2: Working age adults. Vital and health statistics, Series 10. Data from the National Health Survey, pp. 1–47.

  5. Callahan, S. T., & Cooper, W. O. (2005). Uninsurance and health care access among young adults in the United States. Pediatrics, 116(1), 88–95.

    Article  PubMed  Google Scholar 

  6. DeVoe, J. E., Fryerm, G. E., Phillips, R., & Green, L. (2003). Receipt of preventive care among adults: Insurance status and usual source of care. American Journal of Public Health, 93, 786–791.

    Article  PubMed  Google Scholar 

  7. Salganicoff, A., Ranji, U. R., & Wyn, R. (2005). Women and health care: A national profile key findings from the Kaiser Women’s Health Survey. http://www.kff.org/womenshealth/7336.cfm. Accessed 21 Dec 09.

  8. Guttmacher Institute. Contraceptive Needs and Services, 2006. Available at http://www.guttmacher.org/pubs/win/index.html. Accessed 14 Oct 2009.

  9. Gold, R. B., & Alrich, C. (2009). Role of Medicaid family planning waivers and Title X in enhancing access to preconception care. Women’s Health Issues, 18S, S47–S51.

    Google Scholar 

  10. Finer, L. B., Darroch, J. E., & Frost, J. J. (2002). US agencies providing publicly funded contraceptive services in 1999. Perspectives in Sexual and Reproductive Health, 34(1), 15–24.

    Article  Google Scholar 

  11. Gold, R. (2007). Stronger together: Medicaid, title X bring different strengths to family planning effort. Guttmacher Policy Review, 10(2), 13–18.

    Google Scholar 

  12. Felix, H. C., Bronstein, J., Bursac, Z., Stewart, M. K., Foushee, H. R., & Klapow, J. (2009). Family planning provider referral, facilitation behavior, and patient follow-up for abnormal Pap smears. Public Health Reports, 124(5), 733–744.

    PubMed  Google Scholar 

  13. Atrash, H., Jack, B. W., Johnson, K., Coonrod, D. V., Moos, M. K., Stubblefield, P. G., et al. (2008). Where is the “W”oman in MCH? American Journal of Obestrics and Gyneocology, 199(6S2), S257–S396.

    Google Scholar 

  14. Elixhauser, A., Weschler, J. M., Kitzmiller, J. L., Marks, J. S., Bennert, H. W., Jr, Coustan, D. R., et al. (1993). Cost-benefit analysis of preconception care for women with established diabetes mellitus. Diabetes Care, 16(8), 1146–1157.

    Article  PubMed  CAS  Google Scholar 

  15. Dillman, D. (2000). Mail and internet surveys: The tailored design method (2nd ed.). New York: Wiley.

    Google Scholar 

  16. Felix, H. C., Bronstein, J., Bursac, Z., Stewart, K. M., Foushee, R., Klapow, J. (forthcoming). Referral and referral facilitation behavior of family planning providers for women with human immunodeficiency virus (HIV) infection in the Southern US. Journal of Women’s Health.

  17. Hall, M. A., Zheng, B., Dugan, E., Camacho, F., Kidd, K. E., Mishna, A., et al. (2002). Measuring patient’s trust in their primary care providers. Medical Care Research and Review, 59(3), 293–318.

    Article  PubMed  Google Scholar 

  18. Hibbard, J. H., Stockard, J., Mahoney, E. R., & Tusler, M. (2004). Development of the patient activation measure (PAM): Conceptualizing and measuring activation in patients and consumers. Health Services Research, 39(4,Pt.I), 1005–1026.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was sponsored by the Office of Population Affairs, U.S. Public Health Service, DHHS, as a Family Planning Service Delivery Improvement Project. David Rickard, Christine Pino and Thomas Creger provided valuable research assistance. Earlier versions of this work were presented at the 2008 Academy Health Meetings and at the Centers for Disease Control Best Practices for Screening Women of Reproductive Age for Chronic Conditions 2009 conference.

Author information

Authors and Affiliations

  1. Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35294-0022, USA

    Janet M. Bronstein & Joshua Klapow

  2. Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Holly C. Felix & M. Kathryn Stewart

  3. Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Zoran Bursac

  4. Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    H. Russell Foushee

Authors
  1. Janet M. Bronstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Holly C. Felix
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zoran Bursac
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Kathryn Stewart
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Russell Foushee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Joshua Klapow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Janet M. Bronstein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bronstein, J.M., Felix, H.C., Bursac, Z. et al. Providing General and Preconception Health Care to Low Income Women in Family Planning Settings: Perception of Providers and Clients. Matern Child Health J 16, 346–354 (2012). https://doi.org/10.1007/s10995-011-0744-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-011-0744-6

Keywords

Search

Navigation