Clinic-Type Differences in Contraceptive Service Delivery Protocols and Utilization Patterns in South Carolina (SC) and Alabama (AL)
Abstract
Introduction: Access to timely and high-quality contraceptive services is essential for reproductive autonomy and preventing unplanned pregnancy, yet how these services are delivered across safety-net clinic settings may impact access. This study examines differences in contraceptive counseling approaches, counseling training, service delivery protocols, and contraceptive utilization patterns between health departments (HDs) and federally qualified health centers (FQHCs) in SC and AL. Methodology: Using clinic-level data from a cross-sectional survey (2022) of HDs and FQHCs providing contraceptive services in SC and AL, we conducted bivariate analyses to assess differences by clinic type. Variables included counseling approach, counseling training, same-day long-acting reversible contraception (LARC) initiation, Quick Start protocol, and contraceptive method-mix. Chi-square tests were used for categorical variables, and independent-sample t-tests were used to compare mean differences in method-mix. Results: A total of 205 clinics were included in the analysis (102 HDs and 103 FQHCs). FQHCs were significantly more likely than HDs to report patient-centered contraceptive counseling (88.9% vs. 72.3%, p=0.0139), while HDs more frequently reported combined patient-centered and tiered counseling training (p=0.0006). Same-day LARC initiation was reported more often by HDs than FQHCs (44.3% vs. 23.7%, p=0.0027), and HDs also reported higher use of the Quick Start protocol (81.7% vs. 60.3%, p=0.0019). Contraceptive utilization patterns differed significantly: FQHCs reported a higher mean proportion of patients receiving most effective methods (19.7% vs. 9.0%, p = 0.0013) and a lower proportion receiving moderately effective methods compared with HDs. Conclusion: These findings highlight significant differences in contraceptive service delivery by clinic type. FQHCs more frequently reported patient-centered counseling and higher use of the most effective methods, while HDs more often implemented same-day LARC and Quick Start protocols. These differences may reflect variation in funding mechanisms, inventory capacity, and reimbursement structures, hence the need for clinic-specific strategies to improve equitable access to preferred contraceptive methods.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 2:30 PM
Room Number
304
Presentation Type
Oral Presentation
Presentation Subtype
Grad/Comp Orals
Presentation Category
Health
Student Type
Graduate
Faculty Mentor
Kate Beatty
Clinic-Type Differences in Contraceptive Service Delivery Protocols and Utilization Patterns in South Carolina (SC) and Alabama (AL)
304
Introduction: Access to timely and high-quality contraceptive services is essential for reproductive autonomy and preventing unplanned pregnancy, yet how these services are delivered across safety-net clinic settings may impact access. This study examines differences in contraceptive counseling approaches, counseling training, service delivery protocols, and contraceptive utilization patterns between health departments (HDs) and federally qualified health centers (FQHCs) in SC and AL. Methodology: Using clinic-level data from a cross-sectional survey (2022) of HDs and FQHCs providing contraceptive services in SC and AL, we conducted bivariate analyses to assess differences by clinic type. Variables included counseling approach, counseling training, same-day long-acting reversible contraception (LARC) initiation, Quick Start protocol, and contraceptive method-mix. Chi-square tests were used for categorical variables, and independent-sample t-tests were used to compare mean differences in method-mix. Results: A total of 205 clinics were included in the analysis (102 HDs and 103 FQHCs). FQHCs were significantly more likely than HDs to report patient-centered contraceptive counseling (88.9% vs. 72.3%, p=0.0139), while HDs more frequently reported combined patient-centered and tiered counseling training (p=0.0006). Same-day LARC initiation was reported more often by HDs than FQHCs (44.3% vs. 23.7%, p=0.0027), and HDs also reported higher use of the Quick Start protocol (81.7% vs. 60.3%, p=0.0019). Contraceptive utilization patterns differed significantly: FQHCs reported a higher mean proportion of patients receiving most effective methods (19.7% vs. 9.0%, p = 0.0013) and a lower proportion receiving moderately effective methods compared with HDs. Conclusion: These findings highlight significant differences in contraceptive service delivery by clinic type. FQHCs more frequently reported patient-centered counseling and higher use of the most effective methods, while HDs more often implemented same-day LARC and Quick Start protocols. These differences may reflect variation in funding mechanisms, inventory capacity, and reimbursement structures, hence the need for clinic-specific strategies to improve equitable access to preferred contraceptive methods.
