Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status

Dehlendorf, Christine; Ruskin, R.; Grumbach, Kevin; Vittinghoff, Eric; Bibbins‐Domingo, Kirsten; Schillinger, Dean; Steinauer, Jody

doi:10.1016/j.ajog.2010.05.009

Cited by 220 publications

(157 citation statements)

References 35 publications

(33 reference statements)

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“…Using data from the National Survey of Family Growth, we calculated the percent of teens 15-19 who had ever had sex by race to develop race-specific estimates. This percentage is multiplied by the number teens (15)(16)(17)(18)(19) of each race to estimate the number of sexually active teens by race. The number of sexually active teenagers in the United States is the denominator and the pregnancy rate is the numerator of the race specific estimates.…”

Section: Methodsmentioning

confidence: 99%

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

Goodman

Onwumere

Milam

et al. 2017

Obstetrical &Amp; Gynecological Survey

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CONDENSATIONBlack-white health disparities in the rate of unintended pregnancies can be reduced by providing education, reducing access barriers, and providing contraception at no cost. 2009, 2010, and 2011. We estimated an absolute measure (rate difference (RD)) and a relative measure (rate ratio (RR)) to examine Black-White disparities in the rates of unintended pregnancy.Results: While national rates of unintended pregnancy are decreasing, racial disparities in these rates persist. The Black-White rate difference dropped from 158.5 per 1,000 in 2008 to 120.1 per 1,000 in 2011; however, the relative ratio disparity decreased only from 2.6 to 2.5, suggesting that Black sexually active teens in the U.S.have 2.5 times the rate of unintended pregnancy as White teenagers. In the CHOICE Project, there was a decreasing trend in racial disparities in unintended pregnancy rates Draft 12/6/17 Unintended Pregnancies: Reducing Health Disparities Page | 4 among sexually active teens (age 15-19); RR=3.7), 2010 RR=1.2) and 2013-2014 (RD=-1.5; RR=1.0). Conclusions:When barriers to cost, access, and knowledge were removed, such as in the Contraceptive CHOICE Project, Black-White disparities in unintended pregnancy rates among sexually active teens are reduced on both absolute and relative scales.The rate of unintended pregnancy was almost equal between Black and White women compared to large Black-White disparities on the national level. Word Count: 343Draft 12/6/17

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Section: Methodsmentioning

confidence: 99%

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

Goodman

Onwumere

Milam

et al. 2017

Obstetrical &Amp; Gynecological Survey

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“…This finding is consistent with other studies showing that 84% of progesterone injection users are black. 34,35,90 A greater percentage of white subjects (54.3%) than black subjects (28.6%) used the progesterone IUD. Socioeconomic status was not obtained in this study.…”

Section: Use Of Contraception Methodsmentioning

confidence: 98%

“…A patient's race/ethnicity and socioeconomic status have been shown to be factors in a practitioner's decision of recommendation for type of contraception, 35 which may account for why more white women than black women were using intrauterine contraception. Dehlendorf et al (2010) 35 noted in their study on provider recommendations for intrauterine contraception that white women of low socioeconomic status were significantly less likely than white women of high socioeconomic status to have intrauterine contraception recommended to them by their providers.…”

Section: Use Of Contraception Methodsmentioning

confidence: 99%

“…Dehlendorf et al (2010) 35 noted in their study on provider recommendations for intrauterine contraception that white women of low socioeconomic status were significantly less likely than white women of high socioeconomic status to have intrauterine contraception recommended to them by their providers. Race did not have bearing on provider recommendation among women of high socioeconomic status.…”

Section: Use Of Contraception Methodsmentioning

confidence: 99%

“…These secretions are then transferred to a medium, whether in liquid or fixed onto glass slide, and then examined by a pathologist. 35 One of the errors that can occur with cytologic screening accuracy is failure of correct cellular interpretation.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

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The Effect of Progesterone Only Contraception on the Accuracy of Cervical Cytologic interpretation

Collins¹

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Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the US

et al. 2022

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ImportanceLittle is known about the quality of postpartum care or disparities in the content of postpartum care associated with health insurance, rural or urban residency, and race and ethnicity.ObjectivesTo examine receipt of recommended postpartum care content and to describe variations across health insurance type, rural or urban residence, and race and ethnicity.Design, Settings, and ParticipantsThis cross-sectional survey of patients with births from 2016 to 2019 used data from the Pregnancy Risk Assessment Monitoring System (43 states and 2 jurisdictions). A population-based sample of patients conducted by state and local health departments in partnership with the Centers for Disease Control and Prevention were surveyed about maternal experiences 2 to 6 months after childbirth (mean weighted response rate, 59.9%). Patients who attended a postpartum visit were assessed for content at that visit. Analyses were performed November 2021 to July 2022.ExposuresMedicaid or private health insurance, rural or urban residence, and race and ethnicity (non-Hispanic White or racially minoritized groups).Main Outcomes and MeasuresReceipt of 2 postpartum care components recommended by national quality standards (depression screening and contraceptive counseling), and/or other recommended components (smoking screening, abuse screening, birth spacing counseling, eating and exercise discussions) with estimated risk-adjusted predicted probabilities and percentage-point (pp) differences.ResultsAmong the 138 073 patient-respondents, most (59.5%) were in the age group from 25 to 34 years old; 59 726 (weighted percentage, 40%) were insured by Medicaid; 27 721 (15%) were rural residents; 9718 (6%) were Asian, 24 735 (15%) were Black, 22 210 (15%) were Hispanic, 66 323 (60%) were White, and fewer than 1% were Indigenous (Native American/Alaska Native) individuals. Receipt of both depression screening and contraceptive counseling both significantly lower for Medicaid-insured patients (1.2 pp lower than private; 95% CI, –2.1 to –0.3), rural residents (1.3 pp lower than urban; 95% CI, –2.2 to –0.4), and people of racially minoritized groups (0.8 pp lower than White individuals; 95% CI, –1.6 to –0.1). The highest receipt of these components was among privately insured White urban residents (80%; 95% CI, 79% to 81%); the lowest was among privately insured racially minoritized rural residents (75%; 95% CI, 72% to 78%). Receipt of all other components was significantly higher for Medicaid-insured patients (6.1 pp; 95% CI, 5.2 to 7.0), rural residents (1.1 pp; 95% CI, 0.1 to 2.0), and people of racially minoritized groups (8.5 pp; 95% CI, 7.7 to 9.4). The highest receipt of these components was among Medicaid-insured racially minoritized urban residents (34%; 95% CI, 33% to 35%), the lowest was among privately insured White urban residents (19%; 95% CI, 18% to 19%).Conclusions and RelevanceThe findings of this cross-sectional survey of postpartum individuals in the US suggest that inequities in postpartum care content were extensive and compounded for patients with multiple disadvantaged identities. Examining only 1 dimension of identity may understate the extent of disparities. Future studies should consider the content of postpartum care visits.

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Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status

Cited by 220 publications

References 35 publications

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

The Effect of Progesterone Only Contraception on the Accuracy of Cervical Cytologic interpretation

Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the US

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