This is a mixed methods implementation study of women who utilize a syringe exchange program (SEP) in Seattle. This study had two phases: a qualitative needs assessment and implementation of contraceptive services with prospective cohort study.
Phase 1. Qualitative assessment: We conducted individual interviews to assess perceived barriers and facilitators to provision of contraceptive services among staff, as well as clients’ perceived barriers and facilitators to receipt of contraceptive services at the SEP. We used data from this assessment to inform our implementation of contraception at an SEP capable of clinical services.
Phase 2. Implementation: We implemented same-day onsite contraceptive services at the Robert Clewis Center. We reviewed charts over the 6 months of the implementation period to assess documentation of patients’ pregnancy intention, contraceptive utilization, and receipt of preventive reproductive health care. We collected surveys from staff and clients to evaluate and improve the implementation. We conducted a cohort study to assess unmet contraceptie need and reproductive health care behaviors among female clients of the syringe exchange.