Last data update: Mar 10, 2025. (Total: 48852 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Roobol H[original query] |
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Four years of supporting health in all policies initiatives at the local level: 2018-2022
Siegel R , Roberts S , Roobol H , Sharma B , Mwaungulu G Jr . J Public Health Manag Pract 2024 30 (6) 919-923 |
IUD services among primary care practices in New York City
Jacobson L , Garbers S , Helmy H , Roobol H , Kohn JE , Kavanaugh ML . Contraception 2015 93 (3) 257-62 OBJECTIVE: Intrauterine devices (IUDs) are one of the most effective forms of reversible contraception and can reduce unintended pregnancy rates. We explored practice characteristics associated with IUD services across a network of primary care practices in New York City during 2010-2013. STUDY DESIGN: Data were extracted from electronic health records (EHRs) for 253 primary care practices participating in an EHR quality improvement program in New York City. We used diagnostic and procedure codes to count IUD insertions and removals among females aged 10-49 years during 2010-2013. Logistic regression models predicted the likelihood of IUD insertion, removal, or no activity for 2013, based on practice characteristics. We stratified trends in IUD services over time by practice type and specialty. RESULTS: From 2010-2013, the proportion of practices that inserted IUDs increased slightly from 4.7% to 6.3% (p=0.17) and the proportion removing IUDs increased from 8.3% to 12.3% (p<0.01). More than 60% of OB/GYNs and midwives performed insertions or removals each year; fewer than 10% of internal medicine and pediatric providers did so. Community health centers had higher odds of performing removals than independent practices (AOR=10.24, 95% CI: 3.37-31.17). Practices seeing >66% female patients had higher odds of performing both insertions and removals. CONCLUSIONS: From 2010-2013, IUD services increased but remained low among primary care practices in this network. Provider training and system readiness programs should include independent primary care practices, which rarely provide IUDs, to ensure women can receive IUDs or IUD service referrals in the primary care setting. IMPLICATIONS: Much of primary care in the United States takes place in independent practices with one or two providers. Our study of a major urban area found that these types of practices are much less likely to offer IUD services than CHCs. Ensuring that small practices know where to refer women for IUD insertion and removal services is warranted to ensure women's access to IUDs. |
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