Abortion; Attempted, Abortion Early, Abortion in First Trimester
Conditions
Keywords
health equity, medication abortion, telehealth
Brief summary
This study will examine the ways in which telehealth for reproductive healthcare affects timing, costs, and follow-up care; whether telehealth reaches people in areas with greater health inequities; and the attributes of telehealth that patients want. Study surveys will be administered to interested, eligible participants: 2,000 patients seeking abortion care will complete the study, comprising of 2 groups: patients seeking medication abortion care either (1) in-person or (2) via telehealth. This project will address how telehealth services can be optimized for people of color, low-income people, and immigrants to increase digital inclusion and health equity.
Detailed description
Given the novelty of telehealth abortion services and new abortion bans, there is a critical need for research on the role of telehealth for abortion to expand equitable abortion access among groups historically marginalized in healthcare. Outside of abortion care, telehealth appears to 1) bridge geographic disparities,2) facilitate language translation,3) provide privacy and safety for immigrants with varying legal statuses, 4) decrease patient costs, and 5) require less time off work or school. At the same time, telehealth services could exacerbate inequities if patients lack technology, internet connectivity, or digital literacy. Because abortion is overregulated and highly stigmatized, research on telehealth for abortion is vital. The investigators hypothesize that telehealth is associated with several benefits compared to in-person abortion care, but is not yet reaching people in areas with greater health inequities who need these innovations most. This research can also inform the policies in states that are considering ways to support people in banned states.
Interventions
None listed
Sponsors
University of California, San Francisco
Ibis Reproductive Health
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
14 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
* Must be currently or about to be obtaining medication abortion care through in-person or telehealth services
Exclusion criteria
* Not currently or about to be obtaining medication abortion care through in-person or telehealth services
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determine the ways in which telehealth services affect timing and time to care by comparing in-person and telehealth patients | Baseline | Descriptive statistics for the elapsed days from the first pregnancy test to 1) date of the decision to have an abortion, 2) date of first contact with the clinic, 3) date of medication receipt, and 4) date mifepristone (the first medication) was ingested. |
| Determine the ways in which telehealth services affect costs by comparing in-person and telehealth patients | Baseline and 1 week | Report of 1) out-of-pocket costs for the abortion and 2) the costs of related expenses, including transportation, childcare, lost work, and other expenses. |
| Determine the ways in which telehealth services affect follow-up care by comparing in-person and telehealth patients | 1 week | The incidence of unplanned in-person follow-up visits to a clinician, emergency room, or other facility, between participants in the telehealth and in-person groups using logistic regression models. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Investigate the patient preferences for different aspects of telehealth for abortion care among historically marginalized groups | Baseline and 1 week | We will conduct a discrete choice analysis to understand participant preferred choices for hypothetical delivery alternatives to telehealth abortion. |
| Investigate the barriers in telehealth for abortion care in historically marginalized groups | Baseline and 1 week | The barriers to hypothetical delivery alternatives to telehealth abortion between participants in the telehealth and in-person groups using a discrete choice model |
Countries
United States
Contacts
CONTACTUshma Upadhyay, PhD, MPH
CONTACTJennifer Ko, MLIS
PRINCIPAL_INVESTIGATORUshma Upadhyay, PhD, MPH
University of California, San Francisco
Outcome results
None listed