Barriers to Rural Reproductive Health Clinic Utilization & Effective Interventions Used




Franklin, Felina

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Background Community health clinics have surfaced to provide primary care to low-income individuals, but they are currently hurting due to overwhelmingly high no-show rates (Population Reference Bureau, 2016). The rural reproductive clinic in this study, serves a similar population as community health clinics and has found no shows and missed appointments to be significant in the clinic efficiency reports. Patients most likely to miss appointments at community health clinics were found to be younger, African American/Black patients, and lower income (Boshers, 2018; Miller et al., 2015). Interventions are defined as ways the clinic attempted to assist patients to keep appointments including reminder calls, transportation vouchers, etc. (Molfenter, 2013; Ullah et al., 2018). Studies indicate that implementing a program that provides transportation, increasing exposure of social services provided by the clinic, educating patients on the importance of preventative health care decreased barriers to care leading to missed appointments (Boshers, 2018). The purpose of this study was to identify the barriers to patients attending appointments at a rural reproductive clinic and report the most effective interventions used to address those barriers. Methods The data was originally collected for clinic efficiency compliance measures. Agency staffs collected data via phone survey including demographics, reason for missed appointment, distance from clinic, and whether the patient rescheduled the appointment during the call. Calls were made to 611 patients that missed at least one scheduled appointment by not informing clinic staff or called a "no-show". Two-hundred twenty-three (36%) patients were reached by phone. Interventions offered to patients at the time of the call to address the barrier reported included taxi vouchers, childcare and wage subsidies, gas cards, phone call and text/email reminders, and education/clarification on the importance of keeping the appointment or answering questions about offered services or cost. Results Patients most likely to miss appointments were younger (25 and under), Hispanic, female and of lower economic status. The biggest barrier to gathering data was the 61% of unreachable patients due to wrong phone number, no answer, disconnected phone number, etc. The most common reasons for missing an appointment were the patient forgot or unexpected work/school, family illness, transportation, childcare issues, or questions/concerns about the appointment. The most effective intervention used by the clinic was the follow up calls to those who missed an appointment. Almost half (46%) of the calls made to patients resulted in a rescheduled appointment at the time of the call followed by more than half (57%) of patients that were provided education. Conclusions Further investigation is needed to examine how to reach the 61% of patients that were unreachable at the time of this study. There should be comparison studies of other rural reproductive health clinics studied.


Secondary data analysis of originally collected data by Phone Survey


2022 Faculty Research Poster Session and Research Fair, West Texas A&M University, Department of Psychology, Sociology and Social Work, Poster, Reproductive health, Community health clinic


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