Program Fidelity and Patient Satisfaction among Women Served by the Zika Contraception Access Network Program in Puerto Rico

• Published in: Women's health issues 2020-07, Vol.30 (4), p.268-276
• Main Authors: Zapata, Lauren B., Romero, Lisa, Rivera, Maria I., Rivera-Soto, Stephanie K., Hurst, Stacey, Mendoza, Zipatly V., Clayton, Heather B., Bracero, Nabal, Whiteman, Maura K., Lathrop, Eva
• Format: Article
• Language: English
• Subjects: Adult; Contraception - methods; Contraception Behavior; Contraceptive Agents - supply & distribution; Counseling - methods; Disease Outbreaks - prevention & control; Family Planning Services - organization & administration; Female; Health Services Accessibility - organization & administration; Health Services Accessibility - statistics & numerical data; Humans; Patient Satisfaction; Patient-Centered Care; Pregnancy; Puerto Rico - epidemiology; Zika Virus; Zika Virus Infection - epidemiology; Zika Virus Infection - prevention & control
• ISSN: 1049-3867; 1878-4321
• DOI: 10.1016/j.whi.2020.03.007

The Zika Contraception Access Network (Z-CAN) was designed to provide women in Puerto Rico who chose to delay or avoid pregnancy during the 2016–2017 Zika virus outbreak access to high-quality client-centered contraceptive counseling and the full range of reversible contractive methods on the same day and at no cost through a network of trained providers. We evaluated the implementation of Z-CAN from the patient perspective. An online survey, administered to a subset of women served by the Z-CAN program approximately 2 weeks after their initial Z-CAN visit, assessed patient satisfaction and receipt of services consistent with select program strategies: receipt of high-quality client-centered contraceptive counseling, same-day access to the contraceptive method they were most interested in after counseling, and no-cost contraception. Of 3,503 respondents, 85.2% reported receiving high-quality client-centered contraceptive counseling. Among women interested in a contraceptive method after counseling (n = 3,470), most reported same-day access to that method (86.8%) and most reported receiving some method of contraception at no cost (87.4%). Women who reported receiving services according to Z-CAN program strategies were more likely than those who did not to be very satisfied with services. Women who received high-quality client-centered contraceptive counseling and same-day access to the method they were most interested in after counseling were also more likely to be very satisfied with the contraceptive method received. A contraception access program can be rapidly implemented with high fidelity to program strategies in a fast-moving and complex public health emergency setting.