Understanding Patient Perspectives Regarding Long Acting Reversible Contraception: A Qualitative Study to Inform A Key Domain of Implementation Science

Abstract

Background: Evidence has continued to emerge that Long-acting reversible contraception (LARC) is highly effective in preventing unintended pregnancies and induced abortions, but utilization of LARC remains low among US women, particularly among minority and low income women. Aims: We designed this study to develop insights into factors that can better inform urban, predominantly African American women’s decisions to use LARC.Methods: We conducted focus group interviews with women, in conjunction with a community-based organization providing programs for underserved women, in an urban southeastern U.S city with sites in predominantly African American neighborhoods. Results: Key insights from the focus group results for healthcare providers include: the importance of framing discussions with patients within the context of the patients’ goals; the need to acknowledge and respect the support systems that women rely on for child birthing and childcare; recognition of the clinician’s role as a trusted and respected source of information; and the need to understand and be prepared to address much of the inaccurate and misleading information that can interfere with the patients’ optimal choices for contraception. Discussion: A critical component for applying Implementation Science theory to increase utilization of evidence based practices such as LARC requires understanding women’s perspectives of the factors influencing their decisions to use LARC. Conclusion: This study provides important insights into: 1) the potential barriers inherent in minority women’s concerns about LARC, and 2) how these insights can inform implementation strategies such as patient centered counseling and education to overcome those barriers.

Perinatal Women’s Views of Pharmacist-Delivered Perinatal Depression Screening: A Qualitative Study

“…Although the CFIR has frequently been applied when investigating clinical and operational stakeholder perspectives [ 25 , 26 , 27 , 28 ], the framework has been increasingly used in studies exploring patient perspectives [ 29 , 30 , 31 , 32 , 33 , 34 ]. Recently, the CFIR has been applied to explore patient perspectives on health service implementation [ 35 , 36 ] and pharmacy-delivered services [ 37 , 38 ]. While consideration of consumer perspectives when implementing health services was previously uncommon [ 39 ], this has become increasingly recognised as crucial to healthcare service planning and delivery [ 40 , 41 ].…”