^
Research

Contraceptive Research with Real-World Impact

Our research helps transform contraceptive practice and policy in the United States and beyond.

We use large, randomized trials, implementation science, policy analysis to bring evidence to the forefront of clinical practice and policy change. We also connect with our community and youth advisory boards to understand the important concerns of the day and the best approaches to design solutions to strengthen reproductive autonomy. We use this guidance and evidence to develop training interventions, clinic and provider tools, and policy briefs that support contraceptive access, equity, and reproductive autonomy across a variety of local and political contexts.

Our research team includes faculty members from the Philip R. Lee Institute for Health Policy Studies (IHPS), an interdisciplinary health policy research group at UCSF dedicated to translating health research into policy and practice.

Key Highlights

We are currently conducting a large cluster randomized trial called the REACH Youth Study to enhance contraceptive access and equity among young people in the United States, including in highly restrictive policy contexts. Through this study, we aim to design and test interventions that are effective across policy contexts.

Learn more about our REACH Youth Study

BTP Staff Member at REACH Youth Study Recruitment

 

Our research on training clinics to offer their patients a broad range of contraceptive services has enhanced service delivery for patients seeking contraceptive care. Through our research, we developed and tested an intervention to increase clinics’ capacity to offer the full range of contraceptive methods. Results from the trial were a breakthrough, as it was the first successful clinic intervention in a randomized trial to reduce unintended pregnancy among family planning patients. We also ensured person-centered care and shared decision-making, essential components of contraceptive care.

After study completion, we commenced an implementation science, adapting and disseminating our replicable intervention, and now offer a broad array of comprehensive contraceptive trainings, from setting up basic services to advanced techniques and skills. We also offer in-depth training in patient-centered counseling, telemedicine services, and other emerging access modes. We continue to deliver our training to clinics throughout the US to help improve provider skills and contraceptive care nationwide, including in restrictive states. Our training program has now reached 8 million patients across the United States.

Learn more about our contraceptive training program

Beyond the Pill training

 

 

Our research on emergency contraception has significantly increased access to this important pregnancy prevention method, especially for youth with limited access to care. Data from several of our studies were reviewed by the FDA over many years, concurrent with scientific and policy debates over the impact of direct access through pharmacies to the time-sensitive medication. Evidence from our studies informed significant changes at the policy level, with levonorgestrel emergency contraception ultimately becoming available over the counter, with no age restrictions. The research has led to clinical practice and policy changes globally, with emergency contraception now available in pharmacies in most countries.

Watch: Dr. Jennifer Yarger testifies in support of expanded Medi-Cal coverage of telehealth services

In April 2024, Beyond the Pill researcher Dr. Jennifer Yarger presented testimony in support of Assembly Bill 2339, a California State Assembly bill improving telehealth access for California Medical Assistance Program (Medi-Cal) recipients.

In support of the bill, Dr. Yarger presented research findings from a recent survey among young adults revealing the barriers they face in accessing care via phone and video. She noted that despite its advantages for young people in improving privacy and access, almost 25% of those surveyed “said it would be difficult to use phone or video visits for contraceptive services.” Additionally, food and housing insecure young adults had greater difficulty using these services. Asynchronous telehealth can ensure access to care for these patients, as well as other vulnerable populations.

The bill was favorably received and passed in the Committee on Health and is currently under review in the Committee on Appropriations.

Watch Dr. Yarger’s full testimony.

Evidence-Based Patient and Provider Tools

Our research on contraceptive counseling and care directly informs clinical practice through the evidence-based resources we create for patients, providers, and clinic staff. We distribute over 100,000 print and digital materials per year, and our materials are used by providers in all 50 states, Puerto Rico, and Canada.

Explore our full library of evidence-based resources

 

Policy Briefs

Preview thumbnail of State Policies Impact Young People's Use of Their Preferred Contraceptive Method Policy Brief Policy Brief: State Policies Impact Young People's Use of Their Preferred Contraceptive Method

Many young people are not able to use their preferred contraceptive method, with cost being a primary barrier. State policies can make it easier for young people to access contraception of their choice by increasing insurance coverage and reducing cost barriers.
Policy Brief: Medicaid Funding Policy Brief: Medicaid Funding for Planned Parenthood Allows Women to Choose IUDs and Implants

Planned Parenthood provides the essential service of contraception to low-income individuals throughout the US, helping women who otherwise couldn’t afford birth control to participate in the economy and to have healthy families.
Policy Brief: Contraceptive Counseling Policy Brief: Impact of Contraceptive Counseling on Patient Health Outcomes and Health Costs

Contraceptive counseling is an important component of contraceptive services for two key reasons: good counseling can lead to improved contraceptive use and patient health outcomes, and in doing so, it can also help to reduce health care costs.
Policy Brief: Contraceptive Care Policy Brief: Planned Parenthood: Skilled Providers of Contraceptive and High Quality Care

Planned Parenthood providers are specialists in reproductive health care, and offer patient care that stands out for its high quality. Research shows that patients have far greater access to important contraceptive services, such as IUDs, at Planned Parenthood than at other providers.
Policy brief cover page: STIs Policy Brief: Planned Parenthood Provides Essential Services to Reduce the High Rates of Sexually Transmitted Infections and Unintended Pregnancy in the US

Planned Parenthood is a critical provider of women's health care services in the US and this rigorous research with Planned Parenthood highlights the excellent care to address the STI epidemic and reduce unintended pregnancy. 

Selected Translational Research

  1. Yarger J, Hopkins K, Elmes S, Rossetto I, Van Liefde D, De La Melena S, Harper CC. Use of telemedicine to obtain contraception among older adolescents and young adults: inequities by health insurance. Contraception, 2024.

  2. Comfort AB, Alvarez A, Goodman S, Upadhyay U, Mengesha B, Karlin J, Shokat M, Blum M, Harper CC. Provision of DMPA-SC for self-administration in different practice settings during the COVID-19 pandemic: data from providers across the United States. Contraception, 2024.

  3. Hopkins K, Yarger J, Rossetto I, Sanchez A, Brown E, Elmes S, Mantaro T, White K, Harper CC. Use of preferred contraceptive method among young adults in Texas and California: A comparison by state and insurance coverage. PLOS One 31;18(8):e0290726, 2023.

  4. Zuniga C, Blanchard K, Harper CC, Wollum A, Key K, Henderson J. Effectiveness and efficacy rates of progestin-only pills: A comprehensive literature review. Contraception 119, 109925, 2023.

  5. Harper CC, Jones E, Brindis CD, Watson A, Schroeder R, Boyer CB, Edelman A, Trieu S, Yarger J. Educational Intervention among adolescents and young adults on emergency contraception options. Journal of Adolescent Health 72(6):993-996, 2023.

  6. Sebastian RA, Robinson J, Rayburn E, White A, Andersen AM, Cantu I, Harper CC, Goodman S, Kong AS, Jimenez EY. Virtual Intrauterine Device Placement Training Improves Clinician Comfort. Family Medicine, 54(6):452-6, 2022.

  7. Comfort AB, Rao L, Goodman S, Raine-Bennett T, Barney A, Mengesha B, Harper CC. Assessing differences in contraceptive provision through telemedicine among reproductive health providers during the COVID-19 pandemic in the United States, Reproductive Health, 22;19(1):99, 2022.

  8. Yarger J, Schroeder R, Blum M, Cabral M, Perelli B, Harper CC. Concerns about the Cost of Contraception among Young Women Attending Community College. Women’s Health Issues, S1049-3867(21)00028-1, 2021. Editor’s Choice Article for Sept/Oct 2021 issue.

  9. Comfort AB, Rao L, Goodman S, Barney A, Glymph A, Schroeder R, McCulloch C, Harper CC. Improving capacity at school-based health centers to offer adolescents counseling and access to comprehensive contraceptive services. Journal of Pediatric & Adolescent Gynecology 34:26-32, 2021.

  10. Thompson KM, Rocca CH, Stern L. Morfesis J, Goodman S, Steinauer J, Harper, CC. Training contraceptive providers to offer intrauterine devices and implants in contraceptive care: a cluster randomized trial. American Journal of Obstetrics and Gynecology, 218(6), 2018.
  11. Biggs MA, Kaller, S, Harper CC, Freedman L, Mays AR. "Birth control can easily take a back seat": Challenges providing IUDs in community health care settings. Journal of health care for the poor and underserved, 29(1), 228-244, 2018.
  12. El Ayadi AM, Rocca CH, Kohn JE, Velazquez D, Blum M, Newmann SJ, Harper CC. The impact of an IUD and implant intervention on dual method use among young women: Results from a cluster randomized trial. Preventive Medicine 94:1-6, 2017.
  13. Rafie S, Sanaz K, Gray E, Wong M, Gibbs S, Harper CC. Provider Opinions Regarding Expanding Access to Hormonal Contraception in Pharmacies Women's Health Issues pii: S1049-3867(15)00140-1, 2016.
  14. Thompson KM, Rocca CH, Kohn JE, Goodman S, Stern L, Blum M, Speidel JJ, Darney, PD, Harper CC. Public funding for contraception, provider training, and use of highly effective contraceptives: A cluster randomized trial. American Journal of Public Health 106(3):541-546, 2016.
  15. Rocca CH, Thompson KM, Goodman S, Westhoff CL, Harper CC. Funding policies and post-abortion long-acting reversible contraception: Results from a cluster randomized trial. American Journal of Obstetrics & Gynecology, 2016.
  16. Harper CC, Rocca CH, Thompson KM, Morfesis J, Darney PD, Westhoff CL, Speidel JJ. Reductions in pregnancy rates in the USA with long-acting reversible contraception: a cluster randomised trial. Lancet 386: 562–568, 2015.
  17. Biggs A, Malvin J, Harper CC, Brindis C. Factors influencing the provision of long-acting reversible contraception in California. Obstetrics & Gynecology 123:593-601, 2014.
  18. Harper CC, Stratton L, Raine TR, Thompson K, Henderson JT, Blum M, Postlethwaite D, Speidel JJ. Counseling and provision of long-acting reversible contraception in the US: National survey of nurse practitioners. Preventive Medicine 57:883-8, 2013. 
  19. Speidel JJ, Thompson KMJ, Harper CC. Family planning: Much progress but still far to go. Solutions 4:54-61, 2013.
  20. Speidel JJ, Rocca CH, Thompson KM, Harper CC. Pregnancy: Not a disease, but still a health risk. Contraception 88(4):481-4, 2013.
  21. Raine TR, Ricciotti N, Sokoloff A, Brown BA, Hummel A, Harper CC. An over-the-counter simulation study of a single tablet emergency contraceptive in young females. Obstetrics & Gynecology 119:1-8, 2012.
  22. Harper CC, Speidel JJ, Drey EA, Trussell J, Blum M, Darney PD. Copper intrauterine device for emergency contraception: Clinical practice among contraceptive providers. Obstetrics & Gynecology 119:220-6, 2012.
  23. Belden P, Harper CC, Speidel JJ. The copper IUD for emergency contraception, a neglected option. Contraception 85:338-339, 2012.
  24. Harper CC, Henderson JT, Raine TR, Goodman S, Darney PD, Thompson KM, Dehlendorf C , Speidel JJ. Evidence-based IUD practice: family physicians and obstetrician-gynecologists. Family Medicine 44:637-45, 2012.
  25. Thompson KMJ, Speidel JJ, Saporta V, Waxman NJ, Harper CC. Contraceptive policies affect post-abortion provision of long-acting reversible contraception. Contraception 83:41-47, 2011.
  26. Speidel JJ, Harper CC, Shields W. The potential of long-acting reversible contraception to decrease unintended pregnancy. (Editorial) Contraception 78:197-200, 2008.
  27. Harper CC, Blum M, Thiel de Bocanegra H, Darney PD, Speidel JJ, Policar M, Drey E. Challenges in translating evidence to practice: the provision of intrauterine contraception. Obstetrics & Gynecology 111:1359-1369, 2008.
  28. Goodman S, Hendlish SK, Benedict C, Reeves MF, Pera-Floyd M, Foster-Rosales A. Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion. Contraception 78(2):136-42, 2008. 
  29. Goodman S, Hednlish SK, Reeves, MF, Foster-Rosales, A. Impact of immediate postabortal insertion of intrauterine contraception on repeat abortion. Contraception 78(2):143-8, 2008.
  30. Harper CC, Weiss DC, Speidel JJ, Raine-Bennett T. Over the counter access to emergency contraception for teens. Contraception 77:230-233, 2008.
  31. Sambol N, Harper CC, Kim L, Liu CY, Darney P, Raine TR. Pharmacokinetics of single-dose levonorgestrel in adolescents. Contraception 74:104-109, 2006.
  32. Harper CC, Cheong M, Rocca CH, Darney PD, Raine TR. The effect of increased access to emergency contraception among young adolescents. Obstetrics & Gynecology 106:483-491, 2005.
  33. Harper CC, Rocca CH, Darney PD, von Hertzen H, Raine TR. The tolerability of levonorgestrel emergency contraception in adolescents. American Journal of Obstetrics and Gynecology 191:1158-63, 2004.