Evaluation of the Delaware
Contraceptive Access Now Initiative
Researchers at the University of Maryland, College Park (UMD) have partnered with colleagues at the University of Delaware, Newark (UD), and with key Delaware stakeholders, on a systematic, mixed-methods evaluation of the Delaware Contraceptive Access Now (DelCAN) initiative which aims to: (1) reduce unintended pregnancies; (2) reduce Medicaid costs for unintended pregnancies; and (3) support policy development that enables contraceptive access to all women who desire it. The evaluation, led by Dr. Michael Rendall, Professor and Director of the Maryland Population Research Center (MPRC), is designed to understand the DelCAN’s effectiveness and cost-effectiveness, and to derive lessons about mechanisms leading to initial and sustained impacts in Delaware, and to impacts that are generalizable to other states. An organizational plan is built around three Topic Areas, a Data Core, and a Project Management Core. The three topic areas are: (1) Aggregate (State-level) Outcomes and Causal Impacts, led by Dr. Michel Boudreaux, Assistant Professor of Health Policy and Management, UMD; (2) Process Evaluation, led by Dr. Dylan Roby, Associate Professor of Health Policy and Management, UMD; and (3) Attitudes, Beliefs, and Behavior Change, led by Dr. Ann Bell, Associate Professor of Sociology and Criminal Justice, UD. A six-year evaluation period, from 2016 to 2022, is planned. We analyze three periods (in approximate calendar years): baseline (2013-2014); intervention (2015-2019); and post-intervention (2020-2021). The six-year duration of the evaluation is needed first to allow sufficient time for data from key secondary sources, including the Pregnancy Risk Assessment Monitoring System (PRAMS), to emerge, sufficient to cover the intervention period and beginning of the post-intervention period, and second to understand the longer-term effects and sustainability of the DelCAN intervention.
Primary data collection activities include a survey of Title X clinic family planning users and a Statewide Survey of Reproductive-Aged Women that collect information about contraceptive knowledge, attitudes, and beliefs and the social risk factors that shape the use of and attitudes toward contraceptive choices. Changes in provider knowledge, attitudes, and practices are assessed with questions added to the Delaware Division of Public Health’s Primary Care Provider Survey, and through surveys of non-physician providers including physician assistants and nurse practitioners. Structured interviews of providers and patients at reproductive health service clinics, and structured interviews of reproductive-age women recruited in non-clinic settings, are conducted throughout the state and among diverse socio-economic groups in the state. Data Core activities are conducted at the University of Delaware’s Center for Community Research and Service (CCRS, Mary Joan McDuffie, Policy Scientist) and the Center for Drug and Health Studies (CDHS, Senior Scientist Steven Martin), and at the University of Maryland’s MPRC and School of Public Health.