A Step Ahead Foundation (ASAF) was established in 2011 to provide free, long-acting,
reversible contraception (LARC) to women in Memphis and Shelby County in an effort
to prevent unplanned pregnancy, and allow women to plan when and how they choose to
have families. This report provides an overview of the data collected from the first
year of the program. During the first year, ASAF has made significant progress toward
their two primary outcome goals.
Goal 1: Increased Community Outreach Related to LARC
The first goal of ASAF was to increase community outreach related to LARC. In their
startup year, ASAF made considerable effort to raise awareness of the effectiveness
of LARC and the availability of LARC through their program.
• ASAF developed and disseminated marketing materials via health fairs, the internet
(e.g., Facebook, Twitter, ASAF website), radio and television advertisements, articles
in local publications, and appearances on local broadcasts. 60,000 card flyers were
distributed, 50,000 of which were in both English and Spanish.
• ASAF established a call center, which provided information on where to obtain LARC,
scheduled appointments, and arranged transportation to and from clinics. During the
first year, the call center received 2,210 telephone calls.
• ASAF established partnerships with the Memphis Health Center(MHC) and 6 Christ Community
Health Services (CCHS) clinics to recruit women and provide LARC, with ASAF acting
as the payer of last resort.
• In the first year, 1,057 women completed consent forms indicating intent to obtain
LARC or information about LARC. Most were either uninsured (67%) or received TennCare
(21%), and over two thirds of the women had experienced at least one prior pregnancy.
The largest numbers of women who completed the consent process were from the zip codes
38118 (n=107) and 38115 (n=104), areas with high numbers of births in Shelby County.
Goal 2: Increased Use of LARC at Participating Clinics
• ASAF provided training to healthcare providers, which expanded LARC access at the
MHC and 6 CCHS locations.
• In the first year, 431 women received LARC paid in full by ASAF, the payer of last
resort. These included Depo-Provera shots (31%), Mirena and ParaGard IUDs (36%), and
Implanon/Nexplanon (14%). In addition, ASAF paid 76 co-pays for women who eventually
received LARC paid for by Title X, TennCare, and private insurance.
• Services included “well women” checks, prevention, and procedures related to providing
LARC. The average number of appointments per client was 1.65, and the average cost
per patient for all services was $343.55.
• The vast majority of recipients were either uninsured (72%) or received TennCare
(18%), and over 75% of the women who received LARC with ASAF as the payer of last
resort had already experienced at least one pregnancy, indicating significant need
among the women served.
1. Increase outreach efforts in areas with high birth rates, including the following
zip codes: 38127, 38128, 38134, 38016, 38114, 38106, 38125, and 38122.
2. Add health care provider partners in areas with high birth rates that are not already
served by existing partners: 38128, 38134, 38106, 38016, 38018, and 38125.
3. Increase outreach efforts to men, as they have the opportunity to share and influence
their partners’ decisions regarding the type of contraception used. Target areas that
men frequent, such as barber shops.
4. Increase outreach through faith-based partners, including building on faith-based
partners active in Memphis Teen Vision (MemTV).
5. Expand outreach efforts to include neighborhood community centers and Women, Infants,
and Children (WIC)offices.
6. Use recent medical studies demonstrating the efficacy of LARC to develop outreach
materials that specifically target clinicians and healthcare professionals who share
information about contraception with clients. Outreach should also target healthcare
7. Partner with the pharmaceutical companies that make LARC products to promote them
in local clinics.
8. Produce a new video/advertisement featuring women who have recently received LARC
to play in the waiting rooms of ASAF health care provider partners. Messages from
real, recent clients may reduce uncertainty and increase favorability toward LARC.
9. Provide potential patients with information about LARC while in the waiting room
before their appointment to allow time to review options and formulate questions before
meeting with their health care providers. Also, station an outreach specialist in
waiting rooms at high volume times to speak with women about LARC.