Intervention strategies to improve contraceptive access for uninsured and underinsured women in the United States: A scoping review protocol

Access to contraception is an important public health issue in the United States (U.S.), as it plays a fundamental role in preventing unintended pregnancies and improving maternal and child health outcomes. However, significant disparities in access persist in the United States, particularly among uninsured and underinsured women. These women with no or limited health insurance often experience multiple barriers, including cost, limited service availability, inadequate information, lack of access to the full range of contraceptive methods and, leading to unmet needs for contraception. The objective of this scoping review is to map evidence of intervention strategies aimed at improving access to contraceptive services for uninsured and underinsured women in the United States. The review will follow Arksey and OMalleys 2005 five-stage scoping review framework. We will conduct a comprehensive literature search of publications from January 2005 to June 2025 on electronic databases such as PubMed, Scopus, CINAHL, Embase, and Web of Science, as well as ScienceDirect, EMBASE, CINAHL, and PsycINFO. The PCC (Population, Concept, Context) criteria will guide study selection, focusing on interventions targeting uninsured and underinsured women in the U.S. that aim to improve contraceptive access. Two reviewers will independently screen the title, abstract and full text. We will use the TIDieR (Template for Intervention Description and Replication) checklist for data extraction to ensure comprehensive reporting of interventions. We will use narrative synthesis to analyze and summarize findings numerically and thematically, guided by Andersens Behavioral Model of Health Services Use framework. This scoping review will provide a comprehensive overview of intervention efforts aimed at improving access to contraception among uninsured and underinsured women in the U.S. We expect to identify strategies, programs, and policy-related interventions among this population. Based on the findings from this review, recommendations will be made for future research, program development, and policy. Protocol RegistrationReview registration Opens Science Framework: https://doi.org/10.17605/OSF.IO/9G6DN