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California Home Abortion by Telehealth (CHAT) Study

The California Home Abortion by Telehealth (CHAT) Study is a patient-centered, prospective observational study among participants seeking abortion via telehealth services available in California and potentially other states. ANSIRH researchers will partner with organizations that currently provide telehealth medication abortion services to evaluate the feasibility, safety, efficacy, and acceptability of a novel telehealth model of medication abortion provision. By conducting this study, investigators seek to generate evidence of the safety, efficacy, and acceptability of telehealth models which omit ultrasound and/or pelvic exams to assess gestation and send medications to participants by mail or mail-order pharmacy.

Research Aims

To evaluate the provision of clinically supported medication abortion care through online telehealth platforms.
To determine the factors that contribute to participants' decisions to use a telehealth model for medication abortion care and their experience obtaining abortion care through this model.
To measure time to abortion care, rates of efficacy (complete abortion), adverse events, and additional treatment needed post-abortion.

Study Design

Data will be collected prospectively. Participants will access an online platform and will complete a medical screening form; will consult with a clinician via secure messaging, phone call, or videoconference; and will then receive abortion medications by mail. At three time points (immediately following medical screening, at 3-7 days after receipt of mifepristone and misoprostol by mail, and 4 weeks later), participants will complete online surveys that will allow researchers to assess patients’ demographic characteristics, pregnancy and medical history, abortion outcomes, and acceptability of the telehealth medication abortion model of care.

Implications

Telehealth models for medication abortion care have the potential to greatly reduce barriers and expand access. Yet despite evidence from decades of successful self-use of medication abortion around the world, the FDA has continued to place medically unnecessary restrictions on how it is dispensed. The CHAT Study aims to develop evidence to inform state and federal policy related to telehealth for abortion.

Additional Resources