Translating Access Into Utilization: Lessons From the Design and Evaluation of a Health Insurance Web Site to Promote Reproductive Health Care for Young Women in Massachusetts

摘要

With full implementation of the federal Affordable Care Act, millions of previously uninsured reproductive-aged women will have access to sexual and reproductive health (SRH) services. Cost and lack of insurance have been cited by young women as a primary reason for their poor utilization of contraception and other preventive SRH services. In addition to cost, another important barrier to uptake of these services is patient literacy. Women who cannot understand the newly available insurance products are unlikely to use them. It is estimated that one-third of the US adult population lack the literacy skills needed to use printed health information. The uninsured especially are likely to have low health literacy. Any benefit to women from expanded contraceptive access under the federal Affordable Care Act requires provision of educational resources that are easy to comprehend. Following Massachusetts' state-level health care reform implementation in 2007 and availability of new health insurance products in that state, young women in need of SRH services expressed confusion over coverage of contraception. To address this need, a plain-language Web site titled "My Little Black Book for Sexual Health" was developed in 2010 to help young women and help them identify and use the newly available health insurance products.