All talk, little action: A scoping review mapping lifelong learning education strategies in postgraduate medical education.

In 2018, the Executive Office of Health and Human Services for the Commonwealth of Massachusetts solicited applications to fund public health programs to improve access to contraception statewide. A resulting initiative, based at Boston Medical Center and titled Partners in Contraceptive Choice and Knowledge (PICCK), offered Massachusetts birth hospitals a flexible suite of engagements to promote improved access to and quality of contraceptive care, with an emphasis on patient-centered contraceptive counseling, implementing immediate postpartum long-acting reversible contraceptives (LARC), and increasing access to emergency contraception. The PICCK intervention included 19 participating birth hospitals, was customized to each organization, and generally included both didactic activities (such as grand rounds) and support for administrative changes (such as technical assistance with billing, coding, and protocols). PICCK was intentionally constructed as a collaboration between the program staff, participating hospitals, a multidisciplinary health care professional Advisory Committee, and a Community Advisory Board (CAB). This report describes the CAB’s role in and impact on PICCK. CABs are common structures within community-based participatory research, wherein they formalize the community-academic partnership. The goal of the PICCK CAB was to include diverse perspectives of individuals who may utilize services directly or be impacted as family and community members by service quality at Massachusetts birth hospitals. The expertise CAB members drew from their personal experiences complemented the health service delivery expertise of the core team, our professional Advisory Committee, and partner hospitals. Ensuring that programming to promote contraceptive access enhances health equity requires deliberate centering of community voices. Community involvement is a key component of just, equitable, and inclusive programming and research for any public health issue. However, the case of contraceptive access campaigns merits particular emphasis on community involvement due to a history and continuing tradition of abuse and mistrust between marginalized communities and providers of sexual and reproductive health care. Initiatives to improve access to contraception financed by state governments have increased in popularity over the past two decades. Many such programs have focused narrowly on increasing provision of LARC devices, like intrauterine devices and implants, raising concerns about promoting racially and socioeconomically patterned provider-mediated contraceptive coercion. In response, experts have recommended centering community input and needs in such initiatives. While PICCK was intentionally focused on a broad set of goals around contraceptive access, including promoting patient autonomy in contraceptive decision-making, the CAB served as one concrete structure to amplify community voices within all aspects of program implementation.