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The comparative effectiveness of patient- and provider-directed strategies for increasing shared decision making in reproductive health care
Investigator (PI): Thompson, Rachel
Performing Organization (PO): (Current): Dartmouth College, Dartmouth Center for Health Care Delivery Science / (603) 646-2553
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2015
Final Year: 2020
Record Source/Award ID: PCORI/CDR-1403-12221
Funding: Total Award Amount: $2,128,816
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background: In the USA, over half of all pregnancies are unintended. Unintended pregnancy often occurs because women do not have a contraceptive method that fits their needs and lifestyle. It is important to better support women and their providers to compare contraceptive methods together and choose a method based on what matters most to the woman. This process of comparing options together and choosing the one that is best for the individual patient is called shared decision-making. Objectives: We will test two ways of increasing shared decision-making about contraceptive methods in the clinic visit. The first involves women watching a brief video in the waiting room that explains how to ask three simple questions to get good quality information about contraceptive methods. The second involves giving providers tools called Option Grids to help them work with women to compare contraceptive methods and choose a method based on what matters most to the woman. Methods: Clinics that provide contraceptive health care will be divided into four groups. One group will provide care as usual. The other groups will introduce the Video, the Option Grids, or the Video and Option Grids together. We will then survey around 3000 women from the clinics to ask how much shared decision-making took place, what contraceptive method was chosen, and whether that method fits their needs and lifestyle. We will also survey the women 6 months later to ask how they have been using their method, whether they are satisfied with it, and whether they have had an unintended pregnancy. We will compare women's answers to see which way of increasing shared decision-making worked best. Patient outcomes (projected): We think that the amount of shared decision-making about contraceptive methods will be higher in clinics that introduce the Video and/or Option Grids than in the clinics that provide care as usual. We also think that the women receiving care in these clinics will be more likely to choose a method that fits their needs and lifestyle, to be satisfied with their method, to use it correctly, and to avoid unintended pregnancy. Patient and stakeholder engagement: Our patient and stakeholder engagement has included a survey to help us understand the perspectives and needs of over 600 women and contraceptive care providers, as well as more in-depth consultation with key patient and stakeholder representatives. Our four named patient and stakeholder partners have helped plan the research project and will continue to be involved as it is undertaken. Our patient and stakeholder partners will be genuine members of the research team providing input and advice on the basis of their experience and expertise. Anticipated impact: This project will generate useful knowledge on how best to increase shared decision-making about contraceptive methods and support women to avoid unintended pregnancy. This knowledge could also be used to increase shared decision-making in many other health care contexts.
MeSH Terms:
  • Aged
  • Attitude to Health
  • Comparative Effectiveness Research
  • Contraception /*methods
  • Contraceptive Agents /*therapeutic use
  • * Decision Making
  • Female
  • Humans
  • Life Style
  • Patient Participation
  • Patient Satisfaction
  • Pregnancy
  • Program Development
  • Program Evaluation
  • Reproductive Medicine /*organization & administration
  • United States
Country: United States
State: New Hampshire
Zip Code: 03755
UI: 20152114
CTgovId: NCT02759939
Project Status: Completed
Record History: ('2019: Project extended to 2020\n2017: Project extended to 2019',)