{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T14:14:51Z","timestamp":1791728091825,"version":"4.3.4"},"reference-count":28,"publisher":"Guttmacher Institute","issue":"3","license":[{"start":{"date-parts":[[2014,6,24]],"date-time":"2014-06-24T00:00:00Z","timestamp":1403568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p>Long\u2010acting reversible contraceptive (<jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content>) methods are recommended for young women, but access is limited by cost and lack of knowledge among providers and consumers. The Colorado Family Planning Initiative (<jats:styled-content style=\"fixed-case\">CFPI<\/jats:styled-content>) sought to address these barriers by training providers, financing <jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content> method provision at Title X\u2013funded clinics and increasing patient caseload.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Beginning in 2009, 28 Title X\u2013funded agencies in Colorado received private funding to support <jats:styled-content style=\"fixed-case\">CFPI<\/jats:styled-content>. Caseloads and clients\u2019 <jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content> use were assessed over the following two years. Fertility rates among low\u2010income women aged 15\u201324 were compared with expected trends. Abortion rates and births among high\u2010risk women were tracked, and the numbers of infants receiving services through the Special Supplemental Nutrition Program for Women, Infants and Children (<jats:styled-content style=\"fixed-case\">WIC<\/jats:styled-content>) were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>By 2011, caseloads had increased by 23%, and <jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content> use among 15\u201324\u2010year\u2010olds had grown from 5% to 19%. Cumulatively, one in 15 young, low\u2010income women had received a <jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content> method, up from one in 170 in 2008. Compared with expected fertility rates in 2011, observed rates were 29% lower among low\u2010income 15\u201319\u2010year\u2010olds and 14% lower among similar 20\u201324\u2010year\u2010olds. In <jats:styled-content style=\"fixed-case\">CFPI<\/jats:styled-content> counties, the proportion of births that were high\u2010risk declined by 24% between 2009 and 2011; abortion rates fell 34% and 18%, respectively, among women aged 15\u201319 and 20\u201324. Statewide, infant enrollment in <jats:styled-content style=\"fixed-case\">WIC<\/jats:styled-content> declined 23% between 2010 and 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Programs that increase <jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content> use among young, low\u2010income women may contribute to declines in fertility rates, abortion rates and births among high\u2010risk women.<\/jats:p><\/jats:sec>","DOI":"10.1363\/46e1714","type":"journal-article","created":{"date-parts":[[2014,6,24]],"date-time":"2014-06-24T16:11:43Z","timestamp":1403626303000},"page":"125-132","source":"Crossref","is-referenced-by-count":211,"title":["Game Change in Colorado: Widespread Use Of Long\u2010Acting Reversible Contraceptives and Rapid Decline in Births Among Young, Low\u2010Income Women"],"prefix":"10.1363","volume":"46","author":[{"given":"Sue","family":"Ricketts","sequence":"first","affiliation":[{"name":"Epidemiology, Planning and Evaluation Branch, Prevention Services Division Colorado Department of Public Health and Environment  Denver"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Klingler","sequence":"additional","affiliation":[{"name":"Colorado Department of Public Health and Environment"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee","family":"Schwalberg","sequence":"additional","affiliation":[{"name":"Maternal and Child Health Epidemiology and Statistics Program, Altarum Institute  Portland ME"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"259","published-online":{"date-parts":[[2014,6,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e32835686d5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182723b7d"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmq026"},{"key":"e_1_2_9_5_1","volume-title":"Family Planning Annual Report: 2011 National Summary","author":"Fowler CI","year":"2012"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.01.013"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e328354cc62"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2012.10.006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.03.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318273eb56"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2012.10.276"},{"key":"e_1_2_9_12_1","unstructured":"Colorado Department of Public Health and Environment special tabulations of data for 2005 from the Colorado Pregnancy Risk Assessment Monitoring System."},{"key":"e_1_2_9_13_1","unstructured":"Colorado Department of Public Health and Environment Family Planning Program 2008\u20132011 data from the Integrated Registration and Information System IRIS II."},{"key":"e_1_2_9_14_1","unstructured":"Colorado Department of Local Affairs State Demography Office Population by age and gender 2007\u20132012 <https:\/\/dola.colorado.gov\/demog_webapps\/pagCategory.jsf> accessed Feb. 20 2014."},{"key":"e_1_2_9_15_1","unstructured":"Colorado Department of Local Affairs State Demography Office special tabulations of data from the Public Use Microdata Sample of the American Community Survey."},{"key":"e_1_2_9_16_1","volume-title":"Out of Wedlock","author":"Haveman R","year":"2001"},{"key":"e_1_2_9_17_1","unstructured":"Colorado Department of Public Health and Environment special tabulations of data from the Health Statistics Section."},{"key":"e_1_2_9_18_1","unstructured":"Colorado Department of Public Health and Environment Prevention Services Division special tabulations of data from the Colorado Special Supplemental Nutrition Program for Women Infants and Children."},{"key":"e_1_2_9_19_1","unstructured":"Colorado Department of Local Affairs State Demography Office special tabulations of 2008 and 2011 population data."},{"key":"e_1_2_9_20_1","volume-title":"Birth rates for U.S. teenagers reach historic lows for all age and ethnic groups, National Center for Health Statistics (NCHS) data brief, No. 89","author":"Hamilton BE","year":"2012"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820563d3"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.08.003"},{"key":"e_1_2_9_23_1","doi-asserted-by":"crossref","unstructured":"WesthoffCLet al. 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