The Challenge

As one of the great public health achievements of the 20th century, contraception plays a key role in helping people to control timing or prevention of childbirth, thus enabling individuals and families to attain their goals of family size, health, education, and financial security. Yet many Americans experience barriers in accessing contraception, including high costs, misinformation, insurance gaps, institutional policy, and social inequities. Innovative programs to expand access to contraception may hold promise for advancing person-centered care and improving health outcomes at the population and health systems levels. Scientific evidence about the effectiveness, costs, and benefits of these types of programs is only now emerging; much more evidence is needed to inform providers and agencies in making informed clinical and public health policy decisions.

The Project

To better understand the evidence, the Coalition to Expand Contraceptive Access (CECA) collaborated with the Association of State and Territorial Health Officials (ASTHO) to examine the impact of statewide initiatives on a range of outcomes. CECA coordinated a several-year effort to compile scientific analyses and program descriptions from participating partners in order to share evidence-based solutions with the public. The collaboration aimed to share successes and lessons learned in a premier peer-reviewed public health journal.

Our Approach

Far Harbor was pleased to collaborate with CECA as a key scientific partner, helping to guide the statistical and design perspectives. Far Harbor partnered early in the editorial process by providing statistical reviews, comments and recommendations across the seven journal articles documenting the statewide contraceptive access initiatives from selected states: Colorado, Delaware, Louisiana, Massachusetts, New Mexico, South Carolina, and Utah. This set of articles explored the challenges and opportunities for contraceptive access programs, and carefully detailed the utility of various intervention and evaluation components. Contributing authors also discussed critical issues around reproductive justice, community engagement, scaling interventions, and future directions. Our partnership came to fruition with the special issue of the American Journal of Public Health, published in June 2022.

The Impact

The peer-reviewed issue highlights the unique role of statewide contraceptive access initiatives to support contraceptive access, presents emerging evidence, and features invited papers exploring critical issues related to contraceptive access policy. In total, the publication contributes to and strengthens the body of evidence for contraceptive practice, helping to set the stage for a future Centers for Disease Control and Prevention (CDC) Community Guide recommendation. By documenting large-scale contraceptive access initiatives and their impact on sexual and reproductive health, a Community Guide recommendation would have the potential to drive policy, increase implementation of best practices, encourage cross-agency coordination, and generate public funding for similar efforts.