Contraceptive Decision Making Among Latina Immigrants: Developing Theory-Based Survey Items

Abstract

Background: Contraception is important for reproductive autonomy, yet many Latinas do not use contraception consistently despite research reporting a desire to do so. Factors varying in priority and value come into play during contraceptive decision making. When measuring these, relevant survey items may vary by populations. Aim: This study focused on developing an ethnically responsive, patient-centered, content-valid survey for measuring factors that influence contraceptive decision making among immigrant Latinas. Method: Nonpregnant self-identified Latinas ages 15 to 24 years in Baltimore, MD, were recruited from a family planning facility. Using the theory of planned behavior as a theoretical framework and prior formative research, initial survey items were drafted (Step 1). Content validation and cognitive interviewing procedures (Step 2 and Step 3) were used to develop final items. Results: Final items (27) were content-validated by the target population; items reflect important factors and relevant contexts affecting contraceptive decision making among Latinas in Baltimore. Discussion: These theory-based items provide an important contribution to the literature because they measure and explore factors related to contraceptive decision making in an understudied population. Providers might consider these factors during counseling to build patient-centered communication. These items might serve to measure responses to theory of planned behavior–based interventions designed to improve the contraceptive counseling of Latinas.

Tools for patient-centred family planning counselling: A scoping review

“…Future research should expand testing of these tools in low-income countries and other contexts, where they may be hard to use in their current form. Several studies suggest that background characteristics, such as race, ethnicity, age, geographic location, sexual orientation, pregnancy norms, and pregnancy history, affect the acceptance and effectiveness of these family planning tools [ 5 , 31 , 35 , 40 ]. Hence, tailoring the content of the tools to the specific cultural context may increase their effectiveness.…”

“…The 33 full-text documents retained for this scoping review included three theoretical and/or conceptual articles [1,3,6] and three systematic reviews [7,23,25]. Eight studies focused on women's experiences with family planning counselling and counselling preferences [2,4,9,[26][27][28][29][30], one study discussed the process of contraceptive decision-making [5], and five studies focused on measurement of patient-centred family planning care [10,[31][32][33][34]. Only 13 studies discussed a tool for patient-centred family planning care.…”

Contraceptive Decision-Making and the Importance of Side Effect Information Among a Sample of Latinas

“…A 50-item survey (with skip patterns) was administered to 103 participants. Question items were content-validated based on prior formative work with the population 16 and, for this study, focused on participant expectations and values regarding communication with physicians specifically related to contraceptive side effects, contraceptive use and contraceptive use consistency.…”

“…Outcome variables included contraceptive use and consistent contraceptive use. Contraceptive use was defined as responding “Yes” to the question, “Are you (or your partner) currently using anything to prevent pregnancy now (contraception, birth control, family planning)?” If yes, participants were asked to choose from a list of contraceptives: “Which kind of contraception/birth control/family planning are you or your partner using now to keep from getting pregnant?.” 16 …”

“…Specifically, concerns about side effects may play an important role in their use of contraception. 4 , 16–18 …”