What is SINC?
SINC is a single-item, patient-centered screening tool used to identify contraceptive need during clinical encounters. SINC utilizes a direct service-needs approach, asking people what reproductive health services they’re interested in at the time of their visit. This innovative approach to care is aligned with shifts in the reproductive healthcare community to support patient preferences in their care. Aligning care practices with patient preferences is an important facet of providing person-centered reproductive health care.
SINC was developed in partnership with several stakeholders, including reproductive justice experts Drs. Joia Crear-Perry and Jamila Perritt. It uses intentionally specific language around contraceptive care, keeping in mind that common terms like “birth control” elicit negative connotations of reproductive coercion and control among many communities, including Black, Latinx, and other marginalized communities of color.
SINC consists of one item, with binary “yes/no” response options and additional follow-up “no”-response prompts to document related aspects of contraceptive care.
We ask everyone about their reproductive health needs.
Do you want to talk about contraception or pregnancy prevention during your visit today?
If yes: Mark yes and ensure appropriate counseling is provided
If no: There are a lot of reasons why a person wouldn't want to talk about this, and you don't have to share anything you don't want to. Do any of these apply to you? (Mark all that apply.)
- I’m here for something else
- This question does not apply to me
- I prefer not to answer
- I am already using contraception (and what)
- I am unsure or don’t want to use contraception
- I am hoping to become pregnant in the near future
How is SINC being used
SINC may be asked at intake through existing intake health screening workflows or collected during rooming. SINC has a LOINC code, which can be coded into any EHR for documentation and monitoring of need over time. The UCSF team developed an implementation guide to assist clinical providers in operationalizing SINC in their settings. For additional technical assistance, including assistance getting SINC coded into your site’s EHR, please reach out to [email protected].
Several federal programs utilize SINC for assessing contraceptive need. Federally Qualified Health Centers (FQHCs) may use SINC to fulfill their Family Planning Needs Screening requirements, as set by HRSA’s Uniform Data System (UDS) (pictured left). The Family Planning Annual Report (FPAR 2.0) contains SINC as an optional data element for reporting patients screened for contraceptive need.
Contraceptive Care Screeing eCQM (CCS-eCQM) - SINC may also be used as a performance measure of contraceptive need screening, assessing how many patients at a given site were screened for contraceptive need within a year. The UCSF team are working to submit the CCS-eCQM performance measure to the Partnership for Quality Measurement (PQM), a federally recognized arbiter of measure quality and validity, for endorsement.
Contraceptive Care Screening eCQM measure specifications (.ZIP download)
How is SINC different than One Key Question (OKQ) or the Pregnancy Intention Screening Question (PISQ)?
OKQ and PISQ were designed to assess a person’s intention to become pregnant within the next year. In contrast, SINC assesses a person’s need for specific services on the day of their visit. While a person may hope to become pregnant in the next year, they may also want contraception today, and this need would be missed if they were only asked OKQ or PISQ. Data from several statewide surveys have documented that asking people about their desire to prevent pregnancy identifies more people interested in contraceptive care than pregnancy intention-based screening questions.
More information
SINC Implementation guide