Contraceptive Justice Project at EverThrive Illinois: Understanding the Patient/Client Perspective through Focus Groups

Abstract

Introduction: EverThrive Illinois has been working alongside partners and members to identify and address systemic causes of health inequities in Illinois affecting women, children, and families, through lasting policy changes. Recently, they initiated the Contraceptive Justice Project to increase access to all forms of contraception, while considering the impact of ten social determinants of health. As part of the patient/client assessment, a literature review was conducted that revealed common facilitators and barriers to contraceptive access, and major themes related to a number of social determinants of health. The literature review also revealed gaps in data regarding access to contraception for immigrant populations and the transgender community.Methods/Analysis: Four focus groups (N=57) were conducted at various community organizations in Chicago in order to address the gaps in the literature. Focus group notes were analyzed using grounded theory and an iterative process of comparison. A de-identified, open-ended, demographics questionnaire was administered and analyzed using descriptive statistics.Results: Sample consisted of presumed ciswomen (79%) and gender-expansive folks (12%) who self-identified as Latinx (51%), Black (16%), and white (21%). Four major themes emerged from the focus group discussions: sexual and reproductive health, sexual health education, physician experience, and contraception experience. Discussions revealed multiple sources of sexual and reproductive health information and that experiences of trauma were common. Sexual health education yielded positive experiences when curriculum was inclusive, comprehensive, and taught in multiple modalities. Patient-physician experiences were influenced by language, feelings of distrust, and confidentiality. Finally, when discussing contraceptive experiences, participants often mentioned side effects and cited several barriers to access to their preferred method including insurance/cost, providers pushing contraception methods, or being offered limited options.Discussion: In order to increase access to preferred methods of contraception, people seeking contraception must have access to comprehensive, inclusive, trauma-informed, and age-appropriate sexual health education. The patient-physician relationship also must be strengthened by improving communication, using understandable and inclusive language, and respecting people and their choices. Finally, contraception counseling should be RJ informed.

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