Utilizing Pediatric Primary Care Connections to Advance Reproductive Health

The investigators propose to design and test a Spanish-language maternal contraceptive needs screening and care coordination intervention within primary care pediatrics called Conecta. The investigator's goal is to determine if this intervention can reduce unmet contraceptive need among Latina immigrant mothers. The aims of this study are:

Aim 1: To refine Conecta, a stakeholder-informed Spanish language contraceptive needs screening and care coordination intervention for implementation with existing pediatric social needs navigation, Hopkins Community Connection (HCC). The investigators will translate workflow observations into process maps and present and discuss the process maps with stakeholders who will visually assess the stakeholder's role and interaction in the workflow. Stakeholders will focus feedback on specific, practical ways that contraceptive needs screening and care coordination support would be valuable. This feedback will help the investigators build Conecta from the existing scaffolding of the HCC structure.

Aim 2: To conduct a Hybrid Type 1 implementation-effectiveness pilot of Conecta and evaluate 1) Conecta's effectiveness in reducing unmet contraceptive need, and 2) Conecta's

There are four study populations categorized in this study:

• Staff of the Baltimore Medical Systems (BMS) medical practice, which includes clinicians (i.e. M.D., D.O., N.P.), medical assistants, nurses, receptionists;
• Hopkins Community Connection Resource Advocates (i.e. staff) based at the BMS;
• Community health care providers including clinicians, case managers, social workers, and nurses

Eligible BMS patients comprised of the following subpopulations:

• Latinas with a 12 month old child who is a BMS patient;
• Latinas with an infant 0-1 month old who is a BMS patient.

Eligibility criteria by population:

Historical control group inclusion criteria are:

• individuals who identify as Latina AND foreign-born, AND
• communication preference is Spanish AND
• 22 years or older (any parent 21 years or younger is almost always also one of the investigator's patients) AND
• are the biological parent of a 12 month old child who is a BMS patient.

Intervention cohort inclusion criteria are:

• individuals who identify as Latina AND foreign-born, AND
• communication preference is Spanish AND
• 22 years or older AND
• are the biological parent of a < 1 month old who is a BMS patient.

Participant inclusion criteria for Both:

• BMS staff OR Hopkins Community Connection Advocate staff AND
• age 18 years or older.

Participant inclusion criteria for semi-structured interviews:

• Member of intervention cohort group AND child
• has completed 12 months of life AND
• has completed contraceptive need survey.

Participant inclusion criteria for key informant interviews:

• staff member from one of 5 local health care clinics including Baltimore City Department of Health, Planned Parenthood, Women, Infants, and Children, and two federally qualified health centers AND
• direct interaction with Spanish speaking individuals AND
• age 18 years or older.

Exclusion criteria

Individuals with bilateral tubal ligation (permanent contraception) at time of recruitment