Factors influencing women's selection of combined hormonal contraceptive methods after counselling in 11 countries: Results from a subanalysis of the CHOICE study

Bitzer, Johannes; Cupanik, Vladimir; Fait, T; Gemzell‐Danielsson, Kristina; Grob, P; Oddens, B.J.; Pawełczyk, Leszek; Unzeitig, Vít

doi:10.3109/13625187.2013.819077

Cited by 26 publications

(18 citation statements)

References 14 publications

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“…16,17 In addition, there is a small body of evidence supporting the value of both relational and task-oriented communication. Several observational studies in the United States have found a relationship between the interpersonal quality of family planning counseling and contraceptive use.…”

Section: What Is the Evidence That Contraceptive Counseling Matters?mentioning

confidence: 99%

Contraceptive Counseling

Dehlendorf¹,

Krajewski²,

Borrero³

2014

Clinical Obstetrics &Amp; Gynecology

293

143

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Improving the quality of contraceptive counseling is one strategy to prevent unintended pregnancy. We identify aspects of relational and task-oriented communication in family planning care that can assist providers in meeting their patients’ needs. Approaches to optimizing women's experiences of contraceptive counseling include working to develop a close, trusting relationship with patients and using a shared decision-making approach that focuses on eliciting and responding to patient preferences. Providing counseling about side effects and using strategies to promote contraceptive continuation and adherence can also help optimize women's use of contraception.

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Section: What Is the Evidence That Contraceptive Counseling Matters?mentioning

confidence: 99%

Contraceptive Counseling

Dehlendorf¹,

Krajewski²,

Borrero³

2014

Clinical Obstetrics &Amp; Gynecology

293

143

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“…Thirty-seven percent reported that neither of their parents had more than a high school education. Thirty-eight providers participated in the study; on average, they contributed nine visits each (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Visits were well distributed by provider age: Some 37% were with providers younger than 46, while 36% were with providers aged 46-55 and 27% were with providers aged 56 or older.…”

Section: Overall Mention Of Iudsmentioning

confidence: 99%

“…5 In the United States, however, IUD use, while increasing, has remained relatively low; the most recent results from the National Survey of Family Growth indicate that 8% of women are currently using this method. 6 Women' s selection of a new contraceptive method is infl uenced by provider counseling, 7,8 so family planning providers may be contributing to the underuse of IUDs in the United States. Misinformation among providers may be one factor.…”

mentioning

confidence: 99%

Counseling About IUDs: A Mixed‐Methods Analysis

Dehlendorf

Tharayil

Anderson³

et al. 2014

Perspect Sexual Reproductive

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CONTEXT IUDs are infrequently used in the United States. Assessing how counseling about this method is delivered can help identify barriers to IUD use that might be overcome by improving services. METHODS A sample of 342 family planning visits at six clinics in the San Francisco Bay Area in 2009–2012 were audio-recorded, and patients completed surveys both before and after their visits. Descriptive quantitative analyses of counseling were performed, and correlates of IUDs’ being mentioned during counseling were investigated using logistic regression. Qualitative analyses investigated the counseling women received about IUDs generally (in a subset of 42 visits), as well as counseling for women who already had an IUD in place (13 visits) or who felt their provider inappropriately expressed a preference for IUDs (five visits). RESULTS IUDs were mentioned in 75% of visits. Patient-initiated mention of IUDs was more likely in visits by women aged 35 or older than in those by women younger than 20 (odds ratio, 6.4); provider-initiated discussion of this method was less common if the provider was older than 55 than if he or she was younger than 46 (0.3). Providers more often discussed potential adverse effects of IUD use than benefits; counseling often was noninteractive and did not address how patient preferences related to characteristics of IUDs. Counseling was frequently fragmented by the need for return visits or referral elsewhere for insertion. CONCLUSIONS IUD counseling may be improved by enhancing comprehensiveness and patient-centeredness, and by decreasing fragmentation of care.

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“…Studies investigating the effect of counseling have found that over 50% of women who undergo it report that their provider influenced their choice of method,(2) and this influence may be particularly marked with respect to choice of newer methods. (2, 3) Other studies have found that women who experience higher quality interpersonal care have better contraceptive outcomes. (4–7) Quality contraceptive counseling can therefore have a powerful influence on women’s abilities to achieve their reproductive goals.…”

Section: Introductionmentioning

confidence: 99%

Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling

Dehlendorf

Fitzpatrick

Steinauer

et al. 2017

Patient Education and Counseling

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Objective We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection. Methods Drawing upon formative work around women’s preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted. We obtained feedback from patient and provider advisory groups throughout the development process. Results Ninety-six percent of women who used the tool in pilot testing reported that it helped them choose a method, and qualitative interviews indicated acceptability of the tool’s content and presentation. Compared to the control group, women who used the tool demonstrated trends toward increased likelihood of complete satisfaction with their method. Participant responses to cognitive testing were used in tool refinement. Conclusion Our decision support tool appears acceptable to women in the family planning setting. Practice implications Formative evaluation of the tool supports its utility among patients making contraceptive decisions, which can be further evaluated in a randomized controlled trial.

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Factors influencing women's selection of combined hormonal contraceptive methods after counselling in 11 countries: Results from a subanalysis of the CHOICE study

Abstract: Women's choice of CHC methods after contraceptive counselling are influenced by their age, educational background, relationship status, prior unplanned pregnancies and country of residence, as well as age, gender and preferences of their HCP.

Cited by 26 publications

References 14 publications

Contraceptive Counseling

Contraceptive Counseling

Counseling About IUDs: A Mixed‐Methods Analysis

Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling

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