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Patient-centered support for contraceptive decision making
Investigator (PI): Dehlendorf, Christine E
Performing Organization (PO): (Current): University of California, San Francisco, School of Medicine, Department of Family and Community Medicine / (415) 206-8610
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2018
Record Source/Award ID: PCORI/CE-1304-6874
Funding: Total Award Amount: $1,968,389
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Approximately 50% of pregnancies in the United States each year are unintended, which leads to poor health and social outcomes for both women and their children. One factor contributing to the high rate of unintended pregnancy is the fact that many women use birth control that is less effective or stop using their method shortly after initiating it. The family planning visit provides an opportunity to assist women to achieve their reproductive goals through providing adequate information and helping women to choose the birth control method that is best for them. Decision support tools are interventions designed to help ensure that individuals have the information and support they need to make difficult health care decisions. Because choice of a birth control method is a complex decision, with many methods being an option for the majority of women, these tools can help women to think through their options and make the best choice. We have developed a patient-centered, tablet-based tool designed to help women with their choice of a birth control method, with the ultimate goal of helping them to be able to continue their chosen method and decrease their risk of unintended pregnancy. In this research, our aims are as follows: 1) to determine the impact of a decision support tool on whether a woman continues her chosen method, as well as her experience with birth control counseling; 2) to compare the birth control counseling provided to patients who have used the decision support tool prior to their visit and those who have not used the tool through audio recordings of clinic visits; and 3) to assess the experience of providers and clinics with use of the intervention through observation in clinics and surveys, interviews and focus groups. We will accomplish these aims using a cluster randomized trial with approximately 700 patients, with women either using the tool before their visit or receiving usual care. We will survey women after their visit and at 3 and 6 months to assess their experience of counseling and continuation of her chosen birth control method. In addition, we will audio record a sample of visits before and after the tool is introduced into clinics to assess differences in the process of counseling, including whether patients and providers are more likely to engage in shared decision making after the patient has used the tool. Finally, we will compare waiting time and total clinic visit time for patients using the tool and those not using the tool, and perform interviews and surveys of providers and clinic staff about their experience with the tool and their assessment of the effect of the tool on quality of care and on clinic operations. If this tool is found to be effective, we will be prepared to disseminate a patient-centered, tablet-based birth control counseling intervention designed to improve birth control counseling and women's ability to achieve their reproductive goals.
MeSH Terms:
  • Computers, Handheld
  • Contraception /*methods
  • Contraceptive Agents /*therapeutic use
  • Counseling
  • Decision Making
  • * Decision Support Techniques
  • Female
  • Focus Groups
  • Humans
  • Patient-Centered Care /*organization & administration
  • * Pregnancy, Unplanned
  • Quality of Health Care
  • Randomized Controlled Trials as Topic
  • Risk
  • United States
Country: United States
State: California
Zip Code: 94143
UI: 20143531
CTgovId: NCT02078713
Project Status: Completed
Record History: ('2018: Project extended from February 2018 to November 2018. 2017: Project extended to 2018.',)