Association of the quality of interpersonal care during family planning counseling with contraceptive use

Dehlendorf, Christine; Henderson, Jillian T.; Vittinghoff, Eric; Grumbach, Kevin; Levy, Karmit; Schmittdiel, Julie A.; Lee, Jennifer; Schillinger, Dean; Steinauer, Jody

doi:10.1016/j.ajog.2016.01.173

Cited by 170 publications

(176 citation statements)

References 31 publications

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“…In combination with growing evidence supporting the importance of patient-centered care in improving contraceptive outcomes, 37 our findings suggest that individualized counseling that recognizes the diversity of women’s preferences and beliefs may be the most effective strategy to empower women across all racial/ethnic groups to make informed decisions about contraception and achieve the reproductive outcomes they desire.…”

Section: Resultsmentioning

confidence: 59%

Racial/ethnic differences in contraceptive preferences, beliefs, and self-efficacy among women veterans

Callegari

Zhao

Schwarz

et al. 2017

American Journal of Obstetrics and Gynecology

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BACKGROUND Significant racial/ethnic disparities in unintended pregnancy persist in the United States, with the highest rates observed among low-income black and Hispanic women. Differences in contraceptive preferences, beliefs, and self-efficacy may be instrumental in understanding contraceptive behaviors that underlie higher rates of unintended pregnancy among racial/ethnic minorities. OBJECTIVES Our objective was to understand how contraceptive preferences, beliefs, and self-efficacy vary by race and ethnicity among women veterans. STUDY DESIGN We analyzed data from the Examining Contraceptive Use and Unmet Need Study, a national telephone survey of women veterans aged 18–44 years who had received primary care at the Veterans Administration in the prior 12 months. Participants rated the importance of various contraceptive characteristics and described their level of agreement with contraceptive beliefs using Likert scales. Contraceptive self-efficacy was assessed by asking participants to rate their certainty that they could use contraception consistently and as indicated over time using a Likert scale. Multivariable logistic regression was used to examine associations between race/ethnicity and contraceptive attitudes, controlling for age, marital status, education, income, religion, parity, deployment history, and history of medical and mental health conditions. RESULTS Among the 2302 women veterans who completed a survey, 52% were non-Hispanic white, 29% were non-Hispanic black, and 12% were Hispanic. In adjusted analyses, compared with whites, blacks had lower odds of considering contraceptive effectiveness extremely important (adjusted odds ratio; 0.55, 95% confidence interval, 0.40–0.74) and higher odds of considering the categories of does not contain any hormones and prevents sexually transmitted infections extremely important (adjusted odds ratio, 1.94, 95% confidence interval, 1.56–2.41, and adjusted odds ratio; 1.99, 95% confidence interval, 1.57–2.51, respectively). Hispanics also had higher odds than whites of considering the category of does not contain any hormones and prevents sexually transmitted infections extremely important (adjusted odds ratio, 1.72, 95% confidence interval, 1.29–2.28, and adjusted odds ratio, 1.63; 95% confidence interval, 1.21–2.19, respectively). Compared with whites, blacks and Hispanics had higher odds of expressing fatalistic beliefs about pregnancy (adjusted odds ratio, 1.79, 95% confidence interval, 1.35–2.39, and adjusted odds ratio, 1.48, 95% confidence interval, 1.01–2.17, respectively); higher odds of viewing contraception as primarily a woman’s responsibility (adjusted odds ratio, 1.92, 95% confidence interval, 1.45–2.55, and adjusted odds ratio, 1.77; 95% confidence interval, 1.23–2.54, respectively); and lower odds of being very sure that they could use a contraceptive method as indicated over the course of a year (adjusted odds ratio, 0.73, 95% confidence interval, 0.54–0.98, and adjusted odds ratio, 0.66, 95% confidence interval, 0.46–0.96, respect...

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Section: Resultsmentioning

confidence: 59%

Racial/ethnic differences in contraceptive preferences, beliefs, and self-efficacy among women veterans

Callegari

Zhao

Schwarz

et al. 2017

American Journal of Obstetrics and Gynecology

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“…In summary, given that patient experience is an essential component of health care quality, 10 as well as the fact that the experience of contraceptive counseling is linked to contraceptive outcomes, 6 these findings support the development and implementation of shared decision making interventions for contraceptive counseling.…”

Section: Discussionmentioning

confidence: 82%

“…6 In this study, women were recruited at the time of a contraceptive counseling visit from six clinics in the San Francisco Bay Area. Following their visit, they were surveyed about their experience of counseling.…”

Section: Methodsmentioning

confidence: 99%

Shared decision making in contraceptive counseling

Grumbach²,

et al. 2017

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Background Shared decision making (SDM) is a potentially valuable but underexplored approach to contraceptive counseling. Methods We determined the correlation between patient report of SDM and of whether their provider had a method preference with measures of satisfaction. Results Women reporting SDM were more likely to be satisfied with counseling than those reporting a provider-driven decision, and were more likely to be satisfied with their method than those reporting a patient-driven decision. Patients who felt the provider had a method preference were less likely to be satisfied with their method. Conclusions SDM in contraceptive counseling is associated with patient satisfaction.

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“…Nonetheless, there were some study limitations. The dataset did not contain information on the quality of patient-provider interaction during PPCVs (e.g., topics covered, duration of visit, and communication style) that would be better assessed in qualitative studies [23]. Additionally, confounding factors such as breastfeeding were not assessed due to lack of complete data.…”

Section: Discussionmentioning

confidence: 99%

Postpartum Visit Attendance Increases the Use of Modern Contraceptives

Masho

Cha

Charles

et al. 2016

Journal of Pregnancy

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Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV) is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008–2012). Information on the most recent delivery for mothers with singleton births was analyzed (N = 24,619). Routine PPCV (yes, no) and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8%) and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72). Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates.

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Association of the quality of interpersonal care during family planning counseling with contraceptive use

Cited by 170 publications

References 31 publications

Racial/ethnic differences in contraceptive preferences, beliefs, and self-efficacy among women veterans

Racial/ethnic differences in contraceptive preferences, beliefs, and self-efficacy among women veterans

Shared decision making in contraceptive counseling

Postpartum Visit Attendance Increases the Use of Modern Contraceptives

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