How We Help

For more than a decade our team has overseen capacity-building initiatives funded by the New York City Council’s Dedicated Contraceptive Fund to strengthen SRH services. Our sexual and reproductive justice (SRJ)–aligned collaboratives reduce inequities in contraceptive care and help providers meet the needs of the populations they serve by strengthening clinic capacity, ensuring access to contraceptive supplies, and empowering people to make informed reproductive health decisions. Grounded in patient-centered care and centering the voices of those served, these initiatives promote equity and increase the access to and quality of SRH care in SRH clinics, federally qualified health centers (FQHCs) and hospitals that serve people of reproductive age. Through our Quality Improvement Learning Collaborative (QILC) model, we work site staff to facilitate quarterly learning sessions, targeted trainings, individualized technical assistance and quality improvement coaching. Participating sites also receive grants to support on-site stocking of contraceptives and related supplies. Recent collaboratives include:

• 2022-2024: Equitable and Accessible Adolescent Contraceptive Care Capacity Building Initiative
• 2024-2025: Contraceptive Care in the Interconception Period Quality Improvement Learning Collaborative
• 2025-2026: Patient Centered Contraceptive Care in a Challenging Landscape Capacity Building Initiative

This Office of Population Affairs-funded research project sought to improve the access to SRH and Substance Use (SU) care for people who are capable of pregnancy, use substances, and want to either prevent pregnancy or achieve a healthy pregnancy. Through the project, SRH and SU services sites joined together to improve screening, brief interventions and referrals to partner organizations. The project’s first year focused on designing quality-improvement tools, evaluation tools and training curricula to carry out a QILC. This was done in partnership with a Collaborative Advisory Board made up of representatives from seven SRH and SU service sites in NYC. In 2020, we launched the virtual QILC with nine partner sites across New York State. QILC participants increased screening rates; showed reduced bias, increased knowledge and comfort with SRH and SU topics, and higher ratings on client-centered-care practices; and improved access to peer learning, information on best practices, and training and technical assistance.

• Improving Linkages Between Sexual and Reproductive Health and Substance Use Providers: The Partnership to Advance Integrated Referrals. Quality management in health care, 34(2), 97–104. https://doi.org/10.1097/QMH.0000000000000469.

With COVID-19 changing how SRH providers — particularly in NYC — offered contraceptive services, PHS and the NYC Department of Health and Mental Hygiene (NYC DOHMH) designed a new webinar series to help healthcare facility staff conduct inclusive and comprehensive reproductive telehealth services while offering space to discuss challenges and successes in a metropolitan setting. The series was based on conversations and feedback from community partners through the Quality Improvement Network for Contraceptive Access 2.0 project.

Conducted in partnership with NYC DOHMH, this learning collaborative worked to improve sexual and reproductive justice-informed SRH services in primary care, postpartum and post-abortion settings. The project sought to incorporate the RJ framework [1] into contraceptive access quality improvement efforts while prioritizing patient autonomy and choice at seven NYC FQHCs and hospitals.

Improved SRH services in primary care and assessed the effectiveness of a streamlined version of the SRH-CB Program’s pilot project. Funded by the Ira W. DeCamp Foundation and the New York State Health Foundation, the New York State Contraceptive Care Collaborative (NYSCCC) included seven FQHCs and hospitals and implemented a more rigorous evaluation to compare results to the pilot project. Participating sites received coaching and training on quality improvement, contraceptive counseling, insertion and removal of Long-Acting Reversible Contraceptive (LARC), billing and coding and more. Between August 2018 and February 2020, the percent of patients assessed for contraceptive needs rose from 33% to 52% and the percent of non-pregnancy-seeking people who were provided effective contraceptive methods grew from 17% to 45%.

Funded by an anonymous donor, this quality improvement and training-centered collaborative aimed to improve sexual and reproductive health services across 12 FQHC systems in South Carolina. The initiative conducted trainings and created a learning collaborative on comprehensive contraceptive care for FQHCs across the state. Over the course of the initiative, we trained more than 800 clinical staff across 52 sites. Between April 2018 and December 2018, the percent of patients assessed for contraceptive needs rose from 22% to 63% and the percent of non-pregnancy-seeking people provided with an effective contraceptive method increased from 24% to 35%.

With support from the New York City Council, PHS launched a quality improvement learning collaborative to improve adolescent-focused SRH services and contraceptive care for young women in NYC. The collaborative included five adolescent clinics within the NYC Health + Hospitals system, focusing on adolescent-specific priorities such as confidentiality and contraceptive counseling. Participating sites saw dramatic improvements in care delivery. Between February 2017 and June 2018, the percent of sexually-active adolescents assessed for contraceptive needs grew from 79% to 100% and the percent of non-pregnancy seeking adolescents provided with an effective contraceptive method rose from 68% to 94%.

With support from the New York City Council, PHS launched a quality improvement learning collaborative to improve adolescent-focused SRH services and contraceptive care for young women in NYC. The collaborative included five adolescent clinics within the NYC Health + Hospitals system, focusing on adolescent-specific priorities such as confidentiality and contraceptive counseling. Participating sites saw dramatic improvements in care delivery. Between February 2017 and June 2018, the percent of sexually-active adolescents assessed for contraceptive needs grew from 79% to 100% and the percent of non-pregnancy seeking adolescents provided with an effective contraceptive method rose from 68% to 94%.

Conducted in partnership with Columbia University and Ryan Health, this community-based participatory research (CBPR) project examined patient and provider preferences around pregnancy-related conversations and the concept of pregnancy intent. In the pilot, a high percent of the patients asked about their pregnancy intentions stated that they were not seeking pregnancy but did not use contraception. To understand the validity of this “pregnancy intention” screening question, this project conducted in-depth interviews with patients and providers, using interview guides developed by an advisory board of representatives from the Harlem community, NYC, and staff from Ryan Health, PHS and Columbia University. The project resulted in three published manuscripts that continue to inform our work in this field, offering findings from the CBPR process and recommendations from patients and providers on how to conduct pregnancy related conversations.

• “If You Don’t Ask, I’m Not Going to Tell You”: Using Community-Based Participatory Research to Inform Pregnancy Intention Screening Processes for Black and Latina Women in Primary Care. Women’s Health Issues, Volume 30, Issue 1, 25 – 34. 
https://www.ncbi.nlm.nih.gov/pubmed/31562052.
• Building Community Capacity for Qualitative Research to Improve Pregnancy Intention Screening. Progress in Community Health Partnerships: Research, Education, and Action 13(4), 411-426. https://www.ncbi.nlm.nih.gov/pubmed/31866596.
• Primary care providers’ responses to pregnancy intention screening challenges: community-based participatory research at an urban community health centre. Family Practice, Volume 36, Issue 6, December 2019, Pages 797–803. https://doi.org/10.1093/fampra/cmz027.

With funding from the New York State Health Foundation and an anonymous donor, PHS partnered with four non-Title X-funded FQHCs in NYC to launch a pilot QILC focused on improving contraceptive care services. In 2015, the program published its Contraceptive Care Toolkit, which provides tools to help primary care settings improve their provision of contraceptive care. The Centers for Disease Control and Prevention’s (CDC) Providing Quality Family Planning Services [2] guide endorsed many of the best practices implemented in this project, and participating sites saw dramatic improvements in the delivery of care. Between 2014 and 2016, the percent of patients assessed for contraceptive needs increased lept 3% to 80% and the percent of non-pregnancy-seeking women provided with an effective contraceptive method rose from 2% to 55%.