Contraceptive counseling in managed care: preventing unintended pregnancyin adults

Weisman, Carol S.; Maccannon, Deidre Spicer; Henderson, Jillian T.; Shortridge, Emily; Orso, Camille L.

doi:10.1016/s1049-3867(01)00147-5

Cited by 84 publications

(99 citation statements)

References 20 publications

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“…[16][17][18][19][20] Eliciting women's values and needs and understanding their psychosocial context are consistent with patient-centered care and will improve satisfaction with contraceptive decisions. [35][36][37] Likewise, clinicians who are seeing women who have recently experienced unintended pregnancy should recognize that patient-centered counseling can build self-efficacy and empower women to change future health behaviors that put them at risk for unintended pregnancy. [35][36][37] Such counseling should emphasize behaviors, assessment of abilities, and future intentions and then motivate women to develop a contraceptive plan that meets her short-and long-term reproductive goals.…”

Section: Discussionmentioning

confidence: 99%

“…[35][36][37] Likewise, clinicians who are seeing women who have recently experienced unintended pregnancy should recognize that patient-centered counseling can build self-efficacy and empower women to change future health behaviors that put them at risk for unintended pregnancy. [35][36][37] Such counseling should emphasize behaviors, assessment of abilities, and future intentions and then motivate women to develop a contraceptive plan that meets her short-and long-term reproductive goals. 38,39 In addition, women who were using a contraceptive method that required adherence at the time of their unintended pregnancy (i.e., barrier or hormonal methods) may benefit from information and personalized discussion about methods that do not require adherence [i.e., intrauterine devices (IUDs) or implants].…”

Section: Discussionmentioning

confidence: 99%

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Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

Borrero

Moore

et al. 2009

J GEN INTERN MED

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BACKGROUND: Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of unintended pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated. OBJECTIVE:To examine the associations among race/ ethnicity, unintended pregnancy, and tubal sterilization. DESIGN AND PARTICIPANTS:Cross-sectional analysis of data from a nationally representative sample of women aged 15-44 years [65.7% white, 14.8% Hispanic, and 13.9% African American (AA)] who participated in the 2002 National Survey of Family Growth. MAIN MEASURES:Race/ethnicity, history of unintended pregnancy, and tubal sterilization. A logistic regression model was used to estimate the effect of race/ ethnicity on unintended pregnancy while adjusting for socio-demographic variables. A series of logistic regression models was then used to examine the role of unintended pregnancy as a confounder for the relationship between race/ethnicity and sterilization.KEY RESULTS: Overall, 40% of white, 48% of Hispanic, and 59% of AA women reported a history of unintended pregnancy. After adjusting for socio-demographic variables, AA women were more likely (OR: 2.0; 95% CI: 1.6-2.4) and Hispanic women as likely (OR: 1.0; 95% CI: 0.80-1.2) as white women to report unintended pregnancy. Sterilization was reported by 29% of women who had ever had an unintended pregnancy compared to 7% of women who reported never having an unintended pregnancy. In unadjusted analysis, AA and Hispanic women had significantly higher odds of undergoing sterilization (OR: 1.5; 95% CI: 1.3-1.9 and OR: 1.4; 95% CI: 1.2-1.7, respectively). After adjusting for unintended pregnancy, this relationship was attenuated and no longer significant (OR: 1.2; 95% CI: 0.95-1.4for AA women and OR: 1.3; 95% CI: 1.0-1.6 for Hispanic women).CONCLUSION: Minority women, who more frequently experience unintended pregnancy, may choose tubal sterilization in response to prior experiences with an unintended pregnancy.KEY WORDS: unintended pregnancy; minority women; tubal sterilization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

Borrero

Moore

et al. 2009

J GEN INTERN MED

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“…Because provision of contraceptive counseling affects use of contraception (14), which in turn affects rates of unintended pregnancy (15), these findings suggest that policies that increase rates of contraceptive counseling and contraceptive use may be able to reduce the number of women who unintentionally become pregnant while using a class D or X medication. Our finding that prescriptions filled by women who used the most effective methods of contraception were least likely to have documentation of pregnancy within 3 months of filling a class D or X prescription may be a helpful finding for clinicians to emphasize when they talk with their patients about the risks and benefits of using potentially teratogenic medications.…”

Section: Discussionmentioning

confidence: 99%

Documentation of Contraception and Pregnancy When Prescribing Potentially Teratogenic Medications for Reproductive-Age Women

et al. 2007

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“…Limited data support a relationship between counseling quality and contraceptive use, with 1 cross-sectional study finding that women who reported receiving personalized counseling were more likely to be using contraception, 4 and a longitudinal study finding that women were more likely to discontinue the implant if they had felt pressured to use this method. 5 In the health care literature more generally, although studies have documented an association between patients' ratings of the quality of interpersonal care and health outcomes, there is limited research documenting an association between the quality of observed communication behaviors and outcomes or identifying which aspects of communication are influential.…”

mentioning

confidence: 99%

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

Dehlendorf¹,

Henderson

Vittinghoff³

et al. 2016

American Journal of Obstetrics and Gynecology

170

149

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BACKGROUND: Health communication and interpersonal skills are increasingly emphasized in the measurement of health care quality, yet there is limited research on the association of interpersonal care with health outcomes. As approximately 50% of pregnancies in the United States are unintended, whether interpersonal communication influences contraceptive use is of public health importance. OBJECTIVE: The aim of this study was to determine whether the quality of interpersonal care during contraceptive counseling is associated with contraceptive use over time.The PatienteProvider Communication about Contraception study is a prospective cohort study of 348 English-speaking women seen for contraceptive care, conducted between 2009 and 2012 in the San Francisco Bay Area. Quality of communication was assessed using a patient-reported interpersonal quality in family planning care measure based on the dimensions of patient-centered care. In addition, the clinical visit was audio recorded and its content coded according to the validated Four Habits Coding Scheme to assess interpersonal communication behaviors of clinicians. The outcome measures were 6-month continuation of the selected contraceptive method and use of a highly or moderately effective method at 6 months. Results were analyzed using mixed effect logistic regression models controlling for patient demographics, the clinic and the provider at which the visit occurred, and the method selected.

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Contraceptive counseling in managed care: preventing unintended pregnancyin adults

Cited by 84 publications

References 20 publications

Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

Documentation of Contraception and Pregnancy When Prescribing Potentially Teratogenic Medications for Reproductive-Age Women

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

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