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Article ; Online: Telehealth for Women's Preventive Services for Reproductive Health and Intimate Partner Violence: a Comparative Effectiveness Review.

Cantor, Amy G / Nelson, Heidi D / Pappas, Miranda / Atchison, Chandler / Hatch, Brigit / Huguet, Nathalie / Flynn, Brittny / McDonagh, Marian

Journal of general internal medicine

2023  Volume 38, Issue 7, Page(s) 1735–1743

Abstract: Background: Telehealth delivery of preventive health services may improve access to care; however, its effectiveness and adverse effects are unknown. We conducted a comparative effectiveness review on the effectiveness and harms of telehealth ... ...

Abstract Background: Telehealth delivery of preventive health services may improve access to care; however, its effectiveness and adverse effects are unknown. We conducted a comparative effectiveness review on the effectiveness and harms of telehealth interventions for women's reproductive health and intimate partner violence (IPV) services.
Methods: We searched MEDLINE, Cochrane Library, CINAHL, and Scopus for English-language studies (July 2016 to May 2022) for randomized controlled trials (RCTs) and observational studies of telehealth strategies for women's reproductive health and IPV versus usual care. Two investigators identified studies and abstracted data using a predefined protocol. Study quality was assessed using study design-specific standardized methods; disagreements were resolved through consensus.
Results: Eight RCTs, 1 nonrandomized trial, and 7 observational studies (n=10 731) were included (7 studies of contraceptive care and 9 of IPV services). Telehealth interventions to supplement contraceptive care demonstrated similar rates as usual care for contraceptive use, sexually transmitted infections, and pregnancy (low strength of evidence [SOE]); evidence on abortion was insufficient. Outcomes were also similar between telehealth interventions to replace or supplement IPV services and comparators for repeat IPV, depression, posttraumatic stress disorder, fear of partner, coercive control, self-efficacy, and safety behaviors (low SOE). In these studies, telehealth barriers included limited internet access, digital literacy, technical challenges, and confidentiality concerns. Strategies to ensure safety increased telehealth use for IPV services. Evidence on access, health equity, or harms was lacking.
Discussion: Telehealth interventions for contraceptive care and IPV services demonstrate equivalent clinical and patient-reported outcomes versus in-person care, although few studies are available. Effective approaches for delivering these services and how to best mobilize telehealth, particularly for women facing barriers to care remain uncertain.
Trial registration: PROSPERO CRD42021282298.
MeSH term(s) Pregnancy ; Female ; Humans ; Reproductive Health ; Intimate Partner Violence/prevention & control ; Sexually Transmitted Diseases ; Telemedicine ; Contraceptive Agents
Chemical Substances Contraceptive Agents
Language English
Publishing date 2023-01-17
Publishing country United States
Document type Systematic Review ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID 639008-0
ISSN 1525-1497 ; 0884-8734
ISSN (online) 1525-1497
ISSN 0884-8734
DOI 10.1007/s11606-023-08033-6
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