Routine Screening for Pregnancy Intention to Address Unmet Reproductive Health Needs in Two Urban Federally Qualified Health Centers

• Published in: Journal of health care for the poor and underserved 2017-11, Vol.28 (4), p.1477-1486
• Main Authors: Kvach, Elizabeth, Lose, Jane, Marcus, Hayley, Loomis, Lucy
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Adults; Age; Birth control; Child; Counseling; Electronic Health Records; Electronic medical records; Family planning; Female; Funding; Health care; Health facilities; Health needs; Health services; Health Services Needs and Demand; Health Services Research; Health status; Humans; Intention; Low income groups; Mass Screening - statistics & numerical data; Medical screening; Menopausal women; Middle Aged; Motivation; Non-English speakers; Pregnancy; Primary care; Public health; Quality; Quality control; Quality Improvement - organization & administration; Quality management; Reproductive Health; Reproductive sterilization; Sterilization; Urban Health Services - organization & administration; Urban Health Services - statistics & numerical data; Vital signs; Womens health; Young Adult
• ISSN: 1049-2089; 1548-6869; 1548-6869
• DOI: 10.1353/hpu.2017.0128

The goal of this project was to increase rates of screening for pregnancy intention in primary care. Two urban federally qualified health centers with diverse patient populations undertook a quality improvement project to increase rates of routine screening for pregnancy intention among pre-menopausal non-pregnant women ages 12-45 without history of sterilization. Responses were recorded in the electronic medical record (EMR). Screening rates of eligible women increased from 0% to 68.3% and from 49.0% to 80.3% at Sites 1 and 2, respectively. Adolescents were screened at lower rates than adults (p < .0001). There was no significant difference in screening rates between English and non-English speaking patients. Project challenges included cultural relevance to certain patient groups, staff turnover, and time for follow-up counseling. Implementation of routine pregnancy intention screening is important to address unmet reproductive health needs, and can be successfully implemented through an EMR regardless of primary language.