Performance measures for contraceptive care: what are we actually trying to measure?

Dehlendorf, Christine; Bellanca, Helen; Policar, Michael S.

doi:10.1016/j.contraception.2015.02.002

Cited by 38 publications

(22 citation statements)

References 30 publications

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“…As evident in recent discussions regarding whether it is appropriate or desirable to institute quality measures for contraceptive care based on the proportion of women using highly effective methods, there is a tension between a public health perspective focusing on decreasing unintended pregnancy and a patient-centered perspective focused on women's experience with family planning care and reproductive health more generally [47]. While these two goals are not necessarily in conflict on a population level, bringing the public health perspective into individual family planning visits can interfere with the ability to provide patient-centered care.…”

Section: Resultsmentioning

confidence: 97%

“…As such, the provision of contraceptive counseling that emphasizes method efficacy over other method characteristics that may be of interest to the individual could interact with unconscious bias to contribute to inequities in care. Further, as mistrust of family planning providers is not uncommon among black women [46], efforts to promote specific methods may further contribute to suspicion regarding provider's motives and impair therapeutic relationships, regardless of the actual presence or absence of bias [42,47].…”

Section: Provide Relevant Information In Accordance With Patient Prefmentioning

confidence: 96%

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Patient-Centered Contraceptive Counseling: Evidence to Inform Practice

Dehlendorf

Fox

Sobel

et al. 2016

Curr Obstet Gynecol Rep

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Patient centeredness is an increasingly recognized aspect of quality health care. The application of this framework to contraceptive counseling and care has not been well described. We propose a definition of patient-centered contraceptive counseling that focuses on and prioritizes each patient's individual needs and preferences regarding contraceptive methods and the counseling experience. Guided by this definition, we review recent research that has advanced our understanding of how patient-centered contraceptive counseling can be delivered in practice, focusing on how women decide on a contraceptive method, their preferences for counseling, and their experiences with counseling. This research provides evidence that women have diverse preferences around attributes of their contraceptive methods and value personal, supportive relationships with their family planning providers that focus on their individual preferences. We discuss the implications of this research for practice and review recent interventions that incorporate patient centeredness to varying degrees.

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Section: Resultsmentioning

confidence: 97%

Section: Provide Relevant Information In Accordance With Patient Prefmentioning

confidence: 96%

Patient-Centered Contraceptive Counseling: Evidence to Inform Practice

Dehlendorf

Fox

Sobel

et al. 2016

Curr Obstet Gynecol Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…Reporting on these issues using standardised indicators has the potential to help drive quality improvements and influence the extent to which quality improvement efforts are supported by policymakers, philanthropic organisations, researchers, advocates, programme planners, and health care practitioners 20 21…”

Section: Introductionmentioning

confidence: 99%

Identifying indicators for quality abortion care: a systematic literature review

Dennis

Blanchard

Bessenaar

2016

J Fam Plann Reprod Health Care

102

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A systematic review was conducted of 13 peerreviewed articles and eight reports focused on indicators of quality abortion care. A total of 75 indicators of quality abortion were identified; these indicators address a variety of issues including policy, health systems, trained-provider availability, women's decision making, and morbidity and mortality. There is little agreement about indicators for measuring quality abortion care; more work is needed to ensure efforts to assess quality are informed and coordinated. BACKGROUNDBoth in well-resourced and underresourced health systems, it remains challenging to provide quality health services. This results in variation in the standards of health care delivery and in the outcomes of health care within and between health care systems. As it is a key component of ensuring equitable health care and outcomes, there is growing interest in improving the quality of health care across the globe.

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“…These same barriers were found to predict IUD acceptability and interest among 382 young adults in another recent U.S. web-based LARC survey [20]. Related work suggests that patient-centered models of reproductive health care and contraceptive decision-making are urgently needed [24,27–31]. Promising research on IUD self-removal, for instance, may help reduce such barriers [31].…”

Section: Discussionmentioning

confidence: 85%

“I don't know enough to feel comfortable using them:” Women's knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus

et al. 2016

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Objective To assess multiple dimensions of long acting reversible contraception (LARC) knowledge and perceived multi-level barriers to LARC use among a sample of college women. Study Design We conducted an internet-based study of 1,982 female undergraduates at a large mid-western university. Our 55-item survey used a multi-level framework to measure young women’s understanding of, experiences with intrauterine devices (IUD) and implants and their perceived barriers to LARC at individual, health systems, and community levels. The survey included a 20-item knowledge scale. We estimated and compared LARC knowledge scores and barriers using descriptive, bivariate, and linear regression statistics. Results Few college women had used (5%) or heard of (22%) LARC, and most self-reported “little” or “no” knowledge of IUDs (79%) and implants (88%). Women answered 50% of LARC knowledge items correctly (mean 10.4, range 0–20), and scores differed across sociodemographic groups (p-values<0.04). Factors associated with scores in multivariable models included race/ethnicity, program year, sorority participation, religious affiliation and service attendance, employment status, sexual orientation, and contraceptive history. Perceived barriers to IUDs included: not wanting a foreign object in body (44%); not knowing enough about the method (42%); preferring a “controllable” method (42%); cost (27%); and not being in a long-term relationship (23%). Implant results were similar. “Not knowing enough” was women’s primary reason for IUD (18%) and implant (22%) nonuse. Conclusion Lack of knowledge (both perceived and actual) was the most common barrier among many perceived individual, systems, and community-level factors precluding these college women’s LARC use. Findings can inform innovative, multi-level interventions to improve understanding, acceptability, and uptake of LARC on campuses.

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Performance measures for contraceptive care: what are we actually trying to measure?

Cited by 38 publications

References 30 publications

Patient-Centered Contraceptive Counseling: Evidence to Inform Practice

Patient-Centered Contraceptive Counseling: Evidence to Inform Practice

Identifying indicators for quality abortion care: a systematic literature review

“I don't know enough to feel comfortable using them:” Women's knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus

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