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

      Abstract

      Background

      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.

      Methods

      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.

      Results

      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.

      Conclusions

      A contraception access program can be rapidly implemented with high fidelity to program strategies in a fast-moving and complex public health emergency setting.
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      Biography

      Lauren B. Zapata, PhD, MSPH, is a Commander in the United States Public Health Service and a Senior Research Scientist in the Division of Reproductive Health at the CDC. Her research interests include contraception access and safety.

      Biography

      Lisa Romero, DrPH, MPH, is a Health Scientist in the Division of Reproductive Health at the CDC. Her areas of interest include addressing health systems challenges to increase contraception access and reproductive health in emergency preparedness and response efforts.

      Biography

      Maria I. Rivera, MPH, is a Health Communication Specialist in the Division of Foodborne, Waterborne, and Environmental Diseases at the CDC. Her areas of interest include crisis emergency risk communication, emergency preparedness and response, and access to reproductive health services.

      Biography

      Stephanie K. Rivera-Soto, MPH, is a Monitoring, System and Analysis Implementation Specialist. Her areas of interest includes serving communities in need and promoting health awareness.

      Biography

      Stacey Hurst, MPH, is a Health Scientist in the Division of Reproductive Health at the CDC. Her areas of interest include contraception access.

      Biography

      Zipatly V. Mendoza, MPH, is a Senior Program Officer with the CDC Foundation. Her areas of interest include addressing health inequities through systemic changes to increase access to reproductive health services and contraception.

      Biography

      Heather B. Clayton, PhD, MPH, is a Health Scientist in the Division of Adolescent and School Health at CDC. She is a Maternal and Child Health Epidemiologist, with research interests in reproductive health, substance use, health disparities, and emergency responses.

      Biography

      Nabal Bracero, MD, is an obstetrician-gynecologist in San Juan, Puerto Rico. He serves as Vice-Chairman for the Puerto Rico Section of the American College of Obstetricians and Gynecologists and is President and Founder of Puerto Rico Obstetrics and Gynecology (PROGyn).

      Biography

      Maura K. Whiteman, PhD, is an Epidemiologist in the Division of Reproductive Health at the CDC. Her research interests include contraceptive use, provision, and safety.

      Biography

      Eva Lathrop, MD, MPH, is Associate Professor, Emory University School of Medicine in the Department of Gynecology and Obstetrics. Her research interests focus on findings ways to increase access to family planning for women and families in complex emergency settings.