CARE Women’s Health publishes on telehealth for pandemic contraceptive care
Dr. Kate Beatty, faculty in East Tennessee State University College of Public Health, is lead author of an article in the Journal of Rural Health. The article, Contraceptive care service provision via telehealth early in the COVID-19 pandemic at rural and urban federally qualified health centers in 2 southeastern states, investigated telehealth use for contraceptive service provision among rural and urban federally qualified health centers in Alabama and South Carolina during the initial months of the COVID-19 pandemic.
Additional College of Public Health faculty, students, and alumni co-authors include Dr. Michael Smith, Dr. Amal Khoury, Liane Ventura, Dr. Tosin Ariyo, Jordan de Jong, Kristen Surles, and Dr. Deborah Slawson.
At the onset of the COVID-19 pandemic, public health officials advised a reduction in routine health care services. Although the restrictions were important for reducing the transmission of the virus, conserving protective equipment, and protecting health care workers, necessary preventive services became less widely available.
A cross-sectional survey of federally qualified health centers in Alabama and South Carolina was conducted from July-November 2020. A total of 127 centers responded to the survey and were included in the study; 45 rural clinics and 82 urban clinics. The team assessed clinic characteristics and contraceptive provision. The survey included questions related to the scope of contraceptive provision, clinic policies and practices, and organizational characteristics. Telehealth implementation for contraceptive care was assessed and measured by the percentage of clinics reporting telehealth service provision during the pandemic. Facilitators and barriers to telehealth implementation for contraceptive care were assessed by key informant interviews.
Telehealth for contraceptive service provision increased among federally qualified health centers in this study during the early months of the pandemic relative to 2019. However, more urban centers implemented telehealth for contraceptive counseling, emergency contraception, and sexually transmitted infection care relative to rural clinics. These findings have implications for health disparities between rural and urban areas, particularly as rural clinics have less access to public transportation and a lower proportion of patients receiving contraceptive care. Among a national sample, rural clinics were found to be less likely to use telehealth for service provision by late June 2020, and South Carolina was among the states with the least utilization of telehealth.
Barriers to telehealth provision included challenges with funding, limited electronic infrastructure (for both clinics and patients), and reduced staffing capacity. The findings highlight areas for action, which if unaddressed, can exacerbate existing disparities and inequities in health care service provision for residents in rural areas, particularly concerning contraceptive care.