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From Transportation to Telehealth, Reproductive Health Providers Are Overcoming Barriers Across U.S.

Bayer, as part of its work to make reproductive health care more accessible, is providing awards to four innovative nonprofit groups.


Reproductive Health

The Adagio Health mobile unit makes its way through Western Pennsylvania. A Bayer and Direct Relief grant award will help Adagio reach patients and increase reproductive health care access. (Photo courtesy of Adagio Health)

Sometimes the tagline says it all. And in this case, the tagline is “You’re welcome here.”

Adagio Health – a nonprofit organization that offers sexual and reproductive health services to a low-income population in western Pennsylvania – means what they say.

The organization is trying to get more women the health care they need – whether that’s an IUD or implant, an HIV test, or breast and cervical cancer screening – through a mobile unit that travels the state, providing these services in places where they’re hard to come by.

And to do it, they’re launching an education and outreach campaign that’s designed to encourage women to access health services – a campaign that’s funded by Bayer, working in coordination with Direct Relief.

“The focus of this project is to reach people in a way that they can understand and connect to,” said Linda Snyder, the senior director of Adagio’s family planning programs.

A New Undertaking

The Community Health Awards in reproductive health total $160,000 distributed among four different nonprofit reproductive health care providers, each of which will use the money in unique ways.

Adagio is taking their mobile unit on the road, where it will spend ten-hour days parked outside fire stations, churches, and even a popular greenhouse. Their funding will be used to increase awareness of the mobile unit and encourage patients to seek out sexual and reproductive health care.

Maternal and Family Health Services, also in Pennsylvania, is going digital, using the award to launch a telehealth program aimed at a local Spanish-speaking population.

For Planned Parenthood Great Plains, telehealth hasn’t taken off among their patient population – so they’ll use the award to transport patients with transportation barriers to their clinics for sexual and reproductive health care.

And for Planned Parenthood of Indiana and Kentucky, the funding will support reproductive health education programs for incarcerated youth, women in recovery from domestic violence, and other groups – as well as funding scholarships designed to provide effective sex education.

But all of the programs funded by the initiative focus on education, outreach, and access. For Paulina Ospina, Direct Relief’s associate director of maternal and child health, that’s not a coincidence.

Ospina explained that the biggest reasons that people miss out on reproductive health services have to do with lack: of insurance, income, transportation, and education. “These safety net providers are working in exactly the types of communities where we know people are experiencing the highest levels of barriers,” she said.

The awards are focused on eliminating barriers to access, and complement Bayer’s ongoing contribution of IUDs to Direct Relief, which distributes the products to safety net health providers across the United States.

“The point of these awards was to provide funding to help advance strategies that increase access to family planning services by focusing on patient outreach and education, service delivery and point of care,” Ospina said. “These are areas that are often under-resourced for providers working in medically underserved areas.”

A Warm Welcome

For Adagio, which serves a diverse patient population ranging from urban settings to rural communities, nailing their messaging was a challenge.

“The lack of understanding and education about services and what’s available is a problem,” Snyder said. “It deters people from accessing care.”

To create messaging targeted to their patients, Adagio’s staff members collected and combed over patient stories and testimonials to see what was most important to their patients.

What they saw over and over was an emphasis on comfort and lack of stigma. Their providers were kind. The atmosphere was nonjudgmental. Patients felt at ease seeking health services from the mobile unit.

“That’s what we want to turn around and put out there for folks who have never darkened our doorstep,” said Alicia Schisler, Adagio’s chief of external affairs. “We want to have these comfortable spaces.”

Messaging changes depending on whether the audience is urban or rural, Snyder said. An ad targeted to Pittsburgh residents might focus openly on birth control. A rural one, by contrast, might talk about breast and cervical cancer screenings – and feature patient stories from nearby, rural settings.

“That’s going to help me a little. I know that my folks, my neighbors, think this is OK,” Schisler explained.

A Digital Introduction

Adagio may be going on the road, but Maternal and Family Health Services (MFHS) is meeting patients in the digital world.

When Covid-19 hit, MFHS, like many other providers, implemented telehealth. But they quickly noticed a problem, said John Kearney, MFHS’s vice president of program services. The platform wasn’t working for Spanish-speaking patients, and “we didn’t have the resources to speak with these folks and walk them through the software,” he said.

The Community Health Award will change that. MFHS is beginning a new program designed to make digital reproductive health services more available to the Spanish-speaking residents of nearby communities. The program will also come with a navigator who’s from one of those communities and can help new patients connect to MFHS.

Kearney explained that, for their patients, telehealth is a great way to overcome transportation limitations, concerns about immigration status, and language and cultural barriers. “Why force people to come in when they can use their smartphone, when they can use what they have in their hand?” he said.

He’s also hoping that patients who connect to MFHS through telehealth will take advantage of some of the other services that the provider offers, including access to behavioral health and the government Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

That would be “a win for the organization and for the individuals in our area,” he said.

A Free Ride

Planned Parenthood Great Plains turned to telehealth during the pandemic as well. But their experience has led them to try a different approach.

“What we’ve seen in Arkansas specifically is that telehealth has not really picked up,” said Brie Anderson, vice president of health services at Planned Parenthood Great Plains. Anderson credits lack of internet access and comfort with technology as possible causes.

However, she said, transportation was clearly an issue for many of their patients in Arkansas, and they wanted to try taking it out of the equation.

“The area’s pretty wide-reaching…For patients who lack a car, it could take multiple buses and numerous hours to get to us,” Anderson said. “If we reduced the barrier or transportation or reduced the cost of transportation, would we see these patients in our health center?”

For Planned Parenthood Great Plains, the funding will be used to provide transportation through a ride-sharing app to their facilities, which provide everything from STI testing to transgender care.

“People feel incredibly happy that we come to them, that we’re really supportive of their care,” Andersona said. “We were thrilled to have the support and to try this.”

An Educational Approach

Planned Parenthood of Indiana and Kentucky is focusing their award on education. They’ll provide programming for incarcerated youth, pregnant and parenting teens, and women recovering from substance use and domestic violence.

They’ll promote a new, approachable app designed to provide reliable health information. And they’ll fund scholarships to Spark*ED, a virtual program that helps teachers and others who work with youth to become effective sex educators.

When it comes to reaching out to incarcerated and other at-risk youth, the Power Through Choices program will help them “think about how the choices in their lives impact what happens to them” and “empower…them to understand how to take care of themselves and their partners,” said Leslie Montgomery, the group’s education and outreach manager.

Likewise, education for people in recovery will be connected to the issues and choices that they face.

And the Spark*ED program will increase the reach of the group’s impact by increasing the number of people who are qualified to provide trustworthy, positive sex education.

“A lot of the education that is provided for young folks in particular is focused around abstinence, and we try to make sure that we are being comprehensive,” Montgomery said.

A Cascading Effect

For Ospina, part of the joy of the awards is that they allow for “a more holistic approach” to overcoming reproductive health barriers.

Reproductive health doesn’t just affect the person who receives it, Ospina said. It can have far-reaching impacts on the social and economic well-being of an entire community.

“It ends up being something that cascades far beyond that individual person’s health,” she said.

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