"We just need to create as many avenues for access as we possibly can": A Qualitative Analysis of Sexual and Reproductive Health Provider and Administrator Attitudes Toward the Importance and Priority of Telehealth Medication Abortion Services in the U.S. South Restricted; Files Only
Bhandari, Parie (Spring 2023)
Abstract
Introduction
A lack of access to abortion services has severe implications for the health and well-being of pregnant individuals and their families. Given the hostile abortion policy climate, a shortage of abortion clinics, and issues with provider recruitment and retention, abortion seekers in the U.S. South are at a disproportionately high risk of facing barriers to abortion access. Telehealth medication abortion (TMAB) services have the potential to mitigate these barriers and greatly expand access to care. Research on sexual and reproductive health (SRH) provider and administrator attitudes toward and motivations for implementing these services is necessary to understand the TMAB implementation climate in this challenging context.
Methods
This study conducts a secondary analysis of data from the Provider Readiness for Virtual Implementation and Delivery of Medication Abortion Services (PROVIDA) study. Qualitative data regarding perspectives of providers and administrators toward the importance and priority of TMAB was collected during a series of in-depth interviews that took place from June 2021-2022. Data was later analyzed using MAXQDA and results were interpreted.
Results
Four main themes were identified: TMAB is important for patient benefit in mitigating physical, administrative, financial, and privacy-related barriers, TMAB is important for clinic benefit in improving clinic flow and sustainability, the political climate affects participant prioritization of TMAB, and staff hesitance affects clinic prioritization of TMAB. Though provider and administrator attitudes toward the importance of TMAB influenced feelings of prioritization in some cases and vice versa, the two concepts were largely discussed separately and thus priority was not necessarily tied to view of importance.
Discussion
TMAB was found to be particularly important in mitigating physical access barriers for patients and in helping with clinic sustainability. The political climate was found to be the most notable factor influencing participant prioritization of TMAB, and participant perception of staff hesitation to implement TMAB was found to be the most notable factor affecting clinic prioritization. Findings from this study fill a current gap in literature and have both policy and advocacy implications. Future research should use these findings to inform further studies examining the implementation climate of TMAB in the South.
Table of Contents
Table of Contents
Chapter 1: Introduction…………………………………………………………………………..1
Background………………………………………………………………………………. .........1
Problem Statement……………………………………………………………………...…......2
Purpose.…………………………………………………………………………………….........3
Significance……………………………………………………………………………........…..4
Chapter 2: Literature Review………………………………………………………………...….6
Importance of Abortion Services…………………………………………………………....6
Abortion Landscape in the U.S.……………………………………………………….…...10
Telehealth Medication Abortion Services………………………………………………..22
Chapter 3: Methodology……………………………………………………………………..…28
Study Design…………………………………………………………………………..….......28
Population and Recruitment…………………………………………………………...…..28
Data Collection Tools……………………………………………………………………......29
Analysis………………………………………………………………………………..…........30
Chapter 4: Results………………………………………………………………………………..33
Importance of TMAB for Patient Benefit……………………………………………..….33
Importance of TMAB for Clinic Benefit……………………………………………….....37
Political Climate Affects Participant Prioritization of TMAB………………………..40
Staff Hesitance Affects Clinic Prioritization of TMAB………………………………...44
Chapter 5: Discussion………………………………………………………………………..….47
Summary and Current Literature……………………………………………………….....47
Policy and Practice Recommendations…………………………………………………...51
Strengths and Limitations………………………………………………………………......52
Conclusion and Recommendations………………………………………………………..53
Citations……………………………………………………………………………………….......55
About this Master's Thesis
| School | |
|---|---|
| Department | |
| Degree | |
| Submission | |
| Language |
|
| Research Field | |
| Keyword | |
| Committee Chair / Thesis Advisor |
Primary PDF
| Thumbnail | Title | Date Uploaded | Actions |
|---|---|---|---|
|
|
File download under embargo until 18 May 2025 | 2023-04-18 11:12:42 -0400 | File download under embargo until 18 May 2025 |
Supplemental Files
| Thumbnail | Title | Date Uploaded | Actions |
|---|