{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:39:16Z","timestamp":1785231556379,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate telehealth use for contraceptive service provision among rural and urban federally qualified health centers (FQHCs) in Alabama (AL) and South Carolina (SC) during the initial months of the COVID\u201019 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a mixed\u2010methods study using data from the FQHC Contraceptive Care Survey and key informant interviews with FQHC staff in AL and SC conducted in 2020. Differences between rural and urban clinics in telehealth use for contraceptive service provision were assessed with a chi\u2010square test of independence. Interviews were audio recorded, transcribed, and coded to identify facilitators and barriers to telehealth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Telehealth for contraceptive care increased during the early months of the pandemic relative to prepandemic. Fewer rural clinics than urban clinics provided telehealth for contraceptive counseling (16.3% vs 50.6%) (<jats:italic>P<\/jats:italic>= .0002), emergency contraception (0.0% vs 16.1%) (<jats:italic>P<\/jats:italic>= .004), and sexually transmitted infection care (16.3% vs 34.6%) (<jats:italic>P<\/jats:italic>= .031). Key facilitators of telehealth were reimbursement policy, electronic infrastructure and technology, and funding for technology. Barriers included challenges with funding for telehealth, limited electronic infrastructure, and reduced staffing capacity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Differences in telehealth service provision for contraceptive care between rural and urban FQHCs highlight the need for supportive strategies to increase access to care for low\u2010income rural populations, particularly in AL and SC. It is essential for public and private entities to support the implementation and continuation of telehealth among rural clinics, particularly, investing in widespread and clinic\u2010level electronic infrastructure and technology for telehealth, such as broadband and electronic health record systems compatible with telehealth technology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12701","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T11:20:28Z","timestamp":1658488828000},"page":"160-171","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Contraceptive care service provision via telehealth early in the COVID\u201019 pandemic at rural and urban federally qualified health centers in 2 southeastern states"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-3029","authenticated-orcid":false,"given":"Kate","family":"Beatty","sequence":"first","affiliation":[{"name":"Department of Health Services Management and Policy and Center for Applied Research and Evaluation in Women's Health, College of Public Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8297-2203","authenticated-orcid":false,"given":"Michael G.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Health Services Management and Policy and Center for Applied Research and Evaluation in Women's Health, College of Public Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal J.","family":"Khoury","sequence":"additional","affiliation":[{"name":"Department of Health Services Management and Policy and Center for Applied Research and Evaluation in Women's Health, College of Public Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liane M.","family":"Ventura","sequence":"additional","affiliation":[{"name":"Department of Health Services Management and Policy and Center for Applied Research and Evaluation in Women's Health, College of Public Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4013-2764","authenticated-orcid":false,"given":"Oluwatosin","family":"Ariyo","sequence":"additional","affiliation":[{"name":"Department of Health Services Management and Policy and Center for Applied Research and Evaluation in Women's Health, College of Public Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Health Services Management and Policy and Center for Applied Research and Evaluation in Women's Health, College of Public Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Surles","sequence":"additional","affiliation":[{"name":"Department of Health Services Management and Policy and Center for Applied Research and Evaluation in Women's Health, College of Public Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Slawson","sequence":"additional","affiliation":[{"name":"Department of Community and Behavioral Health East Tennessee State University Johnson City Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2020.06.019"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","unstructured":"LindbergLD VandeVusseA MuellerJ KirsteinM. Early Impacts of the COVID\u201019 Pandemic: Findings from the 2020 Guttmacher Survey of Reproductive Health Experiences.","DOI":"10.1363\/2020.31482"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-20-00171"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.11.020"},{"key":"e_1_2_8_6_1","unstructured":"Assistant Secretary for Public Affairs. Telehealth: Delivering Care Safely During COVID\u201019.HHS.gov.2020. Accessed February 9 2021.https:\/\/www.hhs.gov\/coronavirus\/telehealth\/index.html"},{"key":"e_1_2_8_7_1","unstructured":"Center for Connected Health Policy. Current State Laws and Reimbursement Policies.2020. Accessed February 23 2021.https:\/\/www.cchpca.org\/telehealth\u2010policy\/current\u2010state\u2010laws\u2010and\u2010reimbursement\u2010policies?jurisdiction=30&category=All&topic=All"},{"key":"e_1_2_8_8_1","unstructured":"Health Resources and Services Administration. Office for the Advancement of Telehealth. Accessed February 10 2021.https:\/\/www.hrsa.gov\/rural\u2010health\/telehealth\/"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6950a4"},{"key":"e_1_2_8_10_1","unstructured":"WoodS GoldbergD BeesonT et\u00a0al.Health Centers and Family Planning: Results of a Nationwide Study.2013. Accessed February 10 2021.https:\/\/www.rchnfoundation.org\/wp\u2010content\/uploads\/2013\/04\/Health_Centers_and_Family_Planning\u2010final\u20101.pdf"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2013.09.015"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2019378118"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12562"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.29333\/ejeph\/8200"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12459"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa156"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2021.06.002"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","unstructured":"FrostJJ ZolnaMR FrohwirthLF et\u00a0al. Publicly Supported Family Planning Services in the United States: Likely Need Availability and Impact 2016.2019.","DOI":"10.1363\/2019.30830"},{"key":"e_1_2_8_19_1","unstructured":"Office of Population Affairs. Title X Family Planning Directory.2020."},{"key":"e_1_2_8_20_1","unstructured":"FrostJJ FrohwirthLF BladesN ZolnaMR Douglas\u2010HallA BearakJ. Publicly Funded Contraceptive Services at U.S. Clinics 2015.Guttmacher Institute:2017."},{"key":"e_1_2_8_21_1","unstructured":"County Health Rankings and Roadmaps. % Rural in Alabama. Accessed October 20 2021.https:\/\/www.countyhealthrankings.org\/app\/alabama\/2021\/measure\/factors\/58\/data"},{"key":"e_1_2_8_22_1","unstructured":"County Health Rankings and Roadmaps. % Rural in South Carolina. Accessed October 20 2021.https:\/\/www.countyhealthrankings.org\/app\/south\u2010carolina\/2021\/measure\/factors\/58\/data"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2021.101343"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004903"},{"key":"e_1_2_8_25_1","unstructured":"HamiltonA. Qualitative Methods in Rapid Turn\u2010Around Health Services Research. Presented at: December 11 2013. Accessed September 7 2020.https:\/\/www.hsrd.research.va.gov\/for_researchers\/cyber_seminars\/archives\/video_archive.cfm?SessionID=780"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEH.0000000000000073"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124113500475"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/104973230201200611"},{"key":"e_1_2_8_29_1","unstructured":"US Department of Agriculture.Rural\u2010Urban Continuum Codes.Economic Research Service;2013."},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X05279903"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13759"},{"key":"e_1_2_8_32_1","unstructured":"KimJH DesaiE ColeMB. How the Rapid Shift to Telehealth Leaves Many Community Health Centers Behind During the COVID\u201019 Pandemic. Health Affairs Blog.2020. Accessed August 10 2021.https:\/\/www.healthaffairs.org\/do\/10.1377\/hblog20200529.449762\/full\/"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2020.05.006"},{"key":"e_1_2_8_34_1","unstructured":"AndayaE BhatiaR.The Impact of COVID\u201019 on Minority Disparities in Sexual and Reproductive Health Care in New York State.University at Albany SUNY: Scholars Archive;2021."},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.00903"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/1059924X.2020.1814921"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X20916567"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-20-00380"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2021.S1.200517"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.2196\/19045"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa067"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-019-02750-3"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2020.11.006"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12626"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001481"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2020.05.024"}],"container-title":["The Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.12701","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jrh.12701","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.12701","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T21:33:54Z","timestamp":1700861634000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jrh.12701"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,22]]},"references-count":45,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/jrh.12701"],"URL":"https:\/\/doi.org\/10.1111\/jrh.12701","archive":["Portico"],"relation":{},"ISSN":["0890-765X","1748-0361"],"issn-type":[{"value":"0890-765X","type":"print"},{"value":"1748-0361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,22]]},"assertion":[{"value":"2022-07-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}