Contraceptive counseling practices and patient experience: Results from a cluster randomized controlled trial at Planned Parenthood
| Autor: | Jade F. Hillery, Hannah Spector, Leslie M. Kantor, Julia E. Kohn, Gulielma Leonard Fager, Jordan Leon-Atkins, Hannah R. Simons |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Health Personnel Psychological intervention law.invention 03 medical and health sciences 0302 clinical medicine Patient satisfaction Condom Randomized controlled trial law Pregnancy Surveys and Questionnaires Patient experience medicine Humans 030212 general & internal medicine Contraception Behavior 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Quality Improvement Discontinuation Systematic review Contraception Reproductive Medicine Patient Satisfaction Pill Family medicine Family Planning Services Female business |
| Zdroj: | Contraception. 101(1) |
| ISSN: | 1879-0518 |
| Popis: | Systematic reviews of contraceptive counseling interventions have shown inconsistent impact on patient outcomes. The current study assessed the effects of an evidence-informed contraceptive counseling staff training intervention on patient experience, contraceptive selection, and behavior over three months of follow-up.We randomly assigned 10 Planned Parenthood health centers in the Southeastern US to intervention (staff received contraceptive counseling training) and control (usual counseling) groups. From December 2016-June 2017, patients completed surveys immediately post visit (n = 756) and one and three months after. We compared differences in patients' counseling experience (e.g., number of evidence-informed practices experienced, satisfaction with counseling), contraceptive selection, and behavior (e.g., method discontinuation, accurate pill use, condom use) between study groups using mixed effect models with health center specified as a random effect.Seven hundred and fifty-six participants completed the baseline survey; 579 (77%) completed one or both follow-up surveys. The intervention group was more likely to report experiencing all evidence-informed counseling practices (adj. Prevalence Ratio [aPR] = 2.27, 95% CI 1.27, 4.04) with less variation in the number of practices and higher satisfaction with their counseling than the control group (p 0.01). We found no sustained differences in contraceptive behaviors at both one- and three-month follow-up.We found immediate positive effects of the intervention on patients' perceptions of their counseling experience and no differences in changes in contraceptive behavior over time between the study groups.Evidence-based strategies to improve the quality of contraceptive care and subsequent outcomes, while centering patients' needs and preferences, are needed. The contraceptive counseling intervention offers a tool for increasing consistency in contraceptive counseling practices across health centers and improving patient satisfaction. |
| Databáze: | OpenAIRE |
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