Mi Plan: Using a Pediatric-Based Community Health Worker Model to Facilitate Obtainment of Contraceptives Among Latino Immigrant Parents with Contraceptive Needs

Published:August 07, 2022DOI:


      Bilingual community health workers (CHWs) play an important role in helping Latino immigrants with limited English proficiency (LEP) access health care services and information. Contraceptive health care services and Spanish-language contraceptive information are particularly challenging to access for uninsured LEP immigrants. Contraceptive and reproductive care are longitudinal health needs, and pediatric settings pose a unique opportunity to address these needs among parents whose children access pediatric care. The purpose of this study was to pilot the feasibility of a CHW to support parental contraceptives needs within a pediatric setting serving a high number of Latino immigrant families. This article describes Mi Plan/My Plan, a CHW contraceptive counseling and resource navigation pilot program.


      The research team conducted a retrospective analysis of demographic and contraceptive use data from a 15-month CHW pilot within an urban, primary care pediatrics clinic. The CHW provided contraceptive counseling, referral, and appointment coordination. The outcome was desired contraceptive method obtainment within three months of counseling.


      All 311 individuals counseled were Latina mothers with median child age of 3 months. At baseline, 64.3% were using contraception and 76.5% desired to start or change their current method. Among those who desired a change, 47.9% (114/238) obtained their desired method within three months of initial counselor contact.


      Bilingual CHW contraceptive counseling and care coordination is feasible and acceptable in a pediatric setting serving a high number of Latino immigrant families. CHWs in pediatric settings support health care access equity and are relevant to optimal maternal and child health.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Joint Commission Journal on Quality and Patient Safety
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Commonly Asked Questions. Accessed Aug 16, 2022.

        • Cosgrove S
        • et al.
        Community health workers as an integral strategy in the REACH U.S. program to eliminate health inequities.
        Health Promot Pract. 2014; 15: 795-802
        • Palmer-Wackerly AL
        • et al.
        Listening to the voices of community health workers: a multilevel, culture-centered approach to overcoming structural barriers in US Latinx communities.
        Qual Health Res. 2020; 30: 423-436
      2. Migration Policy Institute. Immigrants in New-Destination States. Terrazas A. Feb 8, 2011. Accessed Aug 16, 2022.

        • Jalisi A
        • et al.
        Testimonios, a mental health support group for Latino immigrants in an emergent Latino community.
        J Health Care Poor Underserved. 2018; 29: 623-632
        • Lebrun LA.
        Effects of length of stay and language proficiency on health care experiences among immigrants in Canada and the United States.
        Soc Sci Med. 2012; 74: 1062-1072
        • Gresenz CR
        • et al.
        Health care experiences of Hispanics in new and traditional U.S. destinations.
        Med Care Res Rev. 2012; 69: 663-678
        • Troutman M
        • Rafique S
        • Plowden TC.
        Are higher unintended pregnancy rates among minorities a result of disparate access to contraception?.
        Contracept Reprod Med. 2020 Oct 1; 5: 16
        • McKinney D
        • et al.
        The influence of interpregnancy interval on infant mortality.
        Am J Obstet Gynecol. 2017; 216 (e1–316.e9)
        • Hanley GE
        • et al.
        Interpregnancy Interval and adverse pregnancy outcomes: an analysis of successive pregnancies.
        Obstet Gynecol. 2017; 129: 408-415
        • Haider S
        • et al.
        Reproductive health disparities: a focus on family planning and prevention among minority women and adolescents.
        Glob Adv Health Med. 2013; 2: 94-99
        • Potter JE
        • et al.
        Barriers to postpartum contraception in Texas and pregnancy within 2 years of delivery.
        Obstet Gynecol. 2016; 127: 289-296
        • Verbiest S
        • et al.
        Elevating mothers’ voices: recommendations for improved patient-centered postpartum.
        J Behav Med. 2018; 41: 577-590
      3. US Census Bureau. Demographic Turning Points for the United States: Population Projections for 2020 to 2060. Vespa J, Medina L, Armstrong DM. Mar 2018. (Updated: Feb 2020.) Accessed Aug 16, 2022.

      4. Pew Research Center. Hispanic Women No Longer Account for the Majority of Immigrant Births in the U.S. Livingston G. Aug 8, 2019. Accessed Aug 16, 2022.

        • American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine
        Obstetric Care Consensus no. 9: interpregnancy care.
        Obstet Gynecol. 2019; 133: e51-e72
        • Cheng TL
        • Kotelchuck M
        • Guyer B.
        Preconception women's health and pediatrics: an opportunity to address infant mortality and family health.
        Acad Pediatr. 2012; 12: 357-359
        • Fuentes-Afflick E
        • et al.
        Optimizing health and well-being for women and children.
        Health Aff (Millwood). 2021; 40: 212-218
        • Gregory EF
        • et al.
        Support for self-management and prenatal health behavior change: implications for pediatric promotion of interconception care.
        Glob Pediatr Health. 2018 Mar 26; 5 (2333794X18765368)
        • Srinivasan S.
        Well-child visits provide physicians opportunity to deliver interconception care to mothers.
        Am Fam Physician. 2019 Jun 15; 99: 731
        • Luque JS
        • et al.
        Access to health care for uninsured Latina immigrants in South Carolina.
        BMC Health Serv Res. 2018 May 2; 18: 310
      5. ALTA Language Services. Clinician Cultural and Linguistic Assessment (CCLA). Accessed Aug 16, 2022. Published 2021.

        • Showell NN
        • et al.
        Neighborhood and parental influences on diet and physical activity behaviors in young low-income pediatric patients.
        Clin Pediatr (Phila). 2016; 56: 1235-1243
        • DeCamp LR
        • et al.
        A texting intervention in Latino families to reduce ED use: a randomized trial.
        Pediatrics. 2020; 145e20191405
      6. Reproductive Health National Training Center. Home page. Accessed Aug 16, 2022.

      7. Bixby Center for Global Reproductive Health, University of California, San Francisco. Home page. Accessed Aug 16, 2022.

        • Dehlendorf C
        • et al.
        Shared decision making in contraceptive counseling.
        Contraception. 2017; 95: 452-455
      8. Baltimore City Health Department. Family Planning & Reproductive Health. Accessed Aug 16, 2022. Published 2018.

      9. Planned Parenthood of Maryland. Home page. Accessed Aug 16, 2022.

        • National Quality Forum (NQF)
        Perinatal and Women's Health, Spring 2021 Cycle: CDP Report.
        NQF, Washington, DC2022: 2022 (Accessed Aug 16)
      10. National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development. What Are the Different Types of Contraception? Jan 31, 2017. Accessed Aug 16, 2022

        • Potter JE
        • et al.
        Unmet demand for highly effective postpartum contraception in Texas.
        Contraception. 2014; 90: 488-495
        • Song EY
        • et al.
        The use of prescription medications obtained from non-medical sources among immigrant Latinos in the rural southeastern U.S.
        J Health Care Poor Underserved. 2012; 23: 678-693
        • Downey MM
        • et al.
        More than a destination: contraceptive decision making as a journey.
        Womens Health Issues. 2017; 27: 539-545
        • Scott VK
        • et al.
        Community health workers’ provision of family planning services in low- and middle-income countries: a systematic review of effectiveness.
        Stud Fam Plann. 2015; 46: 241-261
        • Nepal P
        • et al.
        Costing analysis of a pilot community health worker program in rural Nepal.
        Glob Health Sci Pract. 2020 Jun 30; 8: 239-255
        • McKenney KM
        • Martinez NG
        • Yee LM.
        Patient navigation across the spectrum of women's health care in the United States.
        Am J Obstet Gynecol. 2018; 218: 280-286
        • Kwan BM
        • et al.
        RE-AIM in the real world: use of the RE-AIM framework for program planning and evaluation in clinical and community settings.
        Front Public Health. 2019 Nov 22; 7: 345
        • Dehlendorf C
        • et al.
        Development of a patient-reported measure of the interpersonal quality of family planning care.
        Contraception. 2018; 97: 34-40