{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T07:57:53Z","timestamp":1768636673497,"version":"3.49.0"},"reference-count":33,"publisher":"Guttmacher Institute","issue":"2","license":[{"start":{"date-parts":[[2016,5,19]],"date-time":"2016-05-19T00:00:00Z","timestamp":1463616000000},"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":[[2016,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>CONTEXT<\/jats:title><jats:p>Women frequently experience barriers to obtaining effective contraceptives from clinic\u2010based providers. Allowing nurses to dispense hormonal methods during home visits may be a way to reduce barriers and improve \u2010effective contraceptive use.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Between 2009 and 2013, a sample of 337 low\u2010income, pregnant clients of a nurse home\u2010visit program in Washington State were randomly selected to receive either usual care or enhanced care in which nurses were permitted to provide hormonal contraceptives postpartum. Participants were surveyed at baseline and every three months postpartum for up to two years. Longitudinal Poisson mixed\u2010effects regression analysis was used to examine group differences in gaps in effective contraceptive use, and survival analysis was used to examine time until a subsequent pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Compared with usual care participants, enhanced care participants had an average of 9.6 fewer days not covered by effective contraceptive use during the 90 days following a first birth (52.6 vs. 62.2). By six months postpartum, 50% of usual care participants and 39% of enhanced care participants were using a long\u2010acting reversible contraceptive (<jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content>). In analyses excluding <jats:styled-content style=\"fixed-case\">LARC<\/jats:styled-content> use, enhanced care participants had an average of 14.2 fewer days not covered by effective contraceptive use 0\u20133 months postpartum (65.0 vs. 79.2) and 15.7 fewer uncovered days 4\u20136 months postpartum (39.2 vs. 54.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Home dispensing of hormonal contraceptives may improve women's postpartum contraceptive use and should be explored as an intervention in communities where contraceptives are not easily accessible.<\/jats:p><\/jats:sec>","DOI":"10.1363\/48e9816","type":"journal-article","created":{"date-parts":[[2016,5,19]],"date-time":"2016-05-19T22:49:26Z","timestamp":1463698166000},"page":"93-99","source":"Crossref","is-referenced-by-count":7,"title":["Randomized Controlled Trial of Home\u2010Based Hormonal Contraceptive Dispensing for Women At Risk of Unintended Pregnancy"],"prefix":"10.1363","volume":"48","author":[{"given":"Alan L.","family":"Melnick","sequence":"first","affiliation":[{"name":"Department of Family Medicine Oregon Health &amp; 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