{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:37:39Z","timestamp":1784194659525,"version":"3.55.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Equity"],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To explore disparities in ineligibility for medication abortion using no-test screening criteria compared with assessment with testing including ultrasound.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From June 2021 to December 2022, we surveyed patients ages \u226515 seeking abortion at nine recruitment facilities in eight U.S. states before ultrasound; clinicians assessed patients\u2019 eligibility for medication abortion with ultrasound and other testing. Using clinical guidelines and the no-test protocol criteria, we estimated (1) the proportion ineligible by no-test assessment (pregnancy duration and ectopic pregnancy risk factors as reported in patient surveys and clinician-reported assessment of other contraindications) and (2) the proportion ineligible using no-test criteria yet eligible with testing (false positives). We assessed associations between participant characteristics and ineligibility for medication abortion and reasons for ineligibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We approached 2,846 people, of whom 1,591 were eligible for the study. Of the 1,386 who consented and had complete clinician data, 21.1% (306\/1,386) were ineligible with testing, 71.5% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 991\/1,386) were ineligible using no-test criteria, and 51.4% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 713\/1,386) screened false positive. In adjusted analyses, ineligibility using no-test criteria was significantly greater among people ages 15\u201319 (86.8% [105\/121] vs. 71.5% for full sample,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and experiencing food or housing insecurity (75.8% [525\/690] vs. 67.2%[464\/693],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01); people ages 20\u201324 were more likely to screen false positive (56.1% [263\/469] vs. 51.4% for full sample [713\/1,386],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.03). Moderate\/severe pelvic pain was the most common (614\/1,386) patient-reported reason for ineligibility and reported significantly more by people ages 15\u201319, who were nulliparous, and experienced food or housing insecurity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Screening criteria for no-test medication abortion may exclude many people who are eligible, disproportionately excluding certain population groups from getting the care they seek. More research is needed to improve screening criteria to ensure equitable access to no-test medication abortion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/heq.2024.0128","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T12:28:54Z","timestamp":1742992134000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["No-Test Screening Protocols May Disproportionately Exclude Structurally Oppressed Communities Who Could Benefit from Accessing Medication Abortion"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3904-3177","authenticated-orcid":false,"given":"M. Antonia","family":"Biggs","sequence":"first","affiliation":[{"name":"Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Francisco, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Ralph","sequence":"additional","affiliation":[{"name":"Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Francisco, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Ehrenreich","sequence":"additional","affiliation":[{"name":"Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Francisco, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly","family":"Kaller","sequence":"additional","affiliation":[{"name":"Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Francisco, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Blanchard","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health, Cambridge, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deb","family":"Hauser","sequence":"additional","affiliation":[{"name":"Advocates for Youth, Washington, District of Columbia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Kapp","sequence":"additional","affiliation":[{"name":"International Planned Parenthood Federation, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammi","family":"Kromenaker","sequence":"additional","affiliation":[{"name":"Red River Women\u2019s Clinic, Moorhead, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazaleh","family":"Moayedi","sequence":"additional","affiliation":[{"name":"Pegasus Health Justice Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamila","family":"Perritt","sequence":"additional","affiliation":[{"name":"Physicians for Reproductive Health, Washington, District of Columbia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Raymond","sequence":"additional","affiliation":[{"name":"University of Washington, Tacoma, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"White","sequence":"additional","affiliation":[{"name":"Resound Research for Reproductive Health, Austin, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Grossman","sequence":"additional","affiliation":[{"name":"Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Francisco, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2020.04.005"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2020.05.018"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005205"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.0217"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.03.025"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.04.010"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16668"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.conx.2021.100067"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-02834-w"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.conx.2020.100049"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2020-200954"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.18865"},{"key":"e_1_3_6_14_2","unstructured":"Society of Family Planning. #WeCount report April to August 2022 findings. 2022; 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Group using \u2018shield laws\u2019 to provide abortion care in states that ban it. The Guardian. 2023 Jul 23; Available from: https:\/\/www.theguardian.com\/world\/2023\/jul\/23\/shield-laws-provide-abortion-care-aid-access [Last accessed: February21 2024]."},{"key":"e_1_3_6_16_2","unstructured":"Center for Reproductive Rights. Abortion Laws by State. Available from: https:\/\/reproductiverights.org\/maps\/abortion-laws-by-state\/ [Last accessed: February21 2024]."},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1525\/9780520963207"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2010.300062"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001297"},{"key":"e_1_3_6_20_2","first-page":"e45671","volume-title":"The Role of Telehealth in Promoting Equitable Abortion Access in the United States: Spatial Analysis","author":"Koenig LR","year":"2023","unstructured":"Koenig LR, , Becker A, , Ko J, et al. The Role of Telehealth in Promoting Equitable Abortion Access in the United States: Spatial Analysis. JMIR Public Health Surveill; 2023; 9:e45671."},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.31900"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/21.099"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/10815589221140597"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.07.110"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2023.05.002"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.10.006"},{"key":"e_1_3_6_27_2","unstructured":"U.S. Food and Drug Administration. Mifeprex (mifepristone) information. 2021 Dec 16; Available from: https:\/\/www.fda.gov\/drugs\/postmarket-drug-safety-information-patients-and-providers\/mifeprex-mifepristone-information [Last accessed: December25 2021]."},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004082"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2020.01.009"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2020.05.012"},{"key":"e_1_3_6_31_2","unstructured":"National Abortion Federation (NAF). 2024. Clinical policy guidelines for abortion care. 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