Significant Progress in Delaware

Delaware CAN (Contraceptive Access Now), Upstream USA’s statewide program to reduce unplanned pregnancy, has reached some important milestones:

  • We now have an office in Delaware with 9 full-time staff that has trained over 550 clinicians and support staff from 42 different health centers across the state. Our original goal was to train 80 sites by mid-2017 – we’re more than halfway there.
  • The formal evaluation, led by the University of Maryland in partnership with the University of Delaware, was launched in June. This will be a very ambitious evaluation looking at changes in unintended pregnancy rates and positive changes in birth outcomes, impact on Medicaid and other public costs, and changes in the policy environment that had an impact on these outcomes. They will be looking at a comparison geography as well, they will do cost/benefit analyses, and measure changes in attitudes, beliefs and behaviors.
  • Governor Markell continues to champion our work – he addressed a large group of healthcare leaders at the launch of the evaluation.
Upstream USA’s Dr. Aisha Mays speaks with staff from DE Division of Public Health New Castle County State Service Center on May 13, 2016

As always, we are also gathering our own data to help us learn and refine our intervention, and we just received our first preliminary training evaluations. There were statistically significant gains in confidence and knowledge for both clinicians and support staff. Specifically, compared to pre-training:

  • Clinicians and support staff were more knowledgeable about IUDs and implants after the training.
  • Both clinicians and support staff were significantly more likely to correctly identify candidates for IUD insertion after the training.
  • Clinicians and support staff were significantly more likely to be confident in asking about pregnancy intention and their ability to counsel patients on IUDs and implants.

In all the statistics it’s important to remember that these are real lives we are talking about. Here is an excerpt from a powerful story from a health center that had a six-month waiting list of women who wanted an IUD or implant but wasn’t able to provide one – today, this same health center is offering the full range of methods to all women in a single visit:

“We had a 38-year-old mother of 6 who came in for one of her child’s appointments. She mentioned to the pediatrician that she did not want any more kids. Her husband is controlling and would not allow a tubal ligation with the last pregnancy. In addition to receiving resources and counseling on domestic violence, she was also seen same day for an IUD insertion.”

Upstream’s work in Delaware has continued to receive great media mentions. New York Magazine described how Delaware is “reframing the contraception conversation,” and one of our Delaware health centers was featured in their local paper announcing their progress since completing our training.

Please also check out our latest resources:

Thank you for your continued partnership. This work is hard, changing healthcare is not a simple fix, but we’re pleased with our progress to date

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