When counseling a patient who has interacted with the contraceptive decision-support tool My Birth Control, providers are more likely to focus on the patient’s preferences for contraceptive methods, rather than directive or foreclosed counseling on a specific method. That is the major finding of a prospective study in the journal Patient Education and Counseling (PEC), which analyzed 70 audio recordings of counseling visits among 15 providers in four San Francisco safety net clinics.
“There is a need to improve the quality and patient-centeredness of contraceptive counseling, especially given recent trends toward promotion of long-acting reversible contraceptive methods,” said principal investigator Christine Dehlendorf, MD, MAS, a professor of family and community medicine at the University of California, San Francisco (UCSF). To address this issue, the investigators developed the digital My Birth Control, which provides women information about their birth control options and prints out their preferences, which in turn can be shared with providers during counseling.
“We wanted to see what the effect of this tool was on provider behavior by comparing counseling before and after implementation of My Birth Control,” Dr. Dehlendorf told Contemporary OB/GYN.
The 72 English-speaking women who participated in the study were ages 15 to 45, not currently pregnant, with a desire to discuss starting or switching a contraceptive method, but not wanting pregnancy within the subsequent 7 months. They were randomized to a preimplementation recording (arecording done before the tool was used in clinic)(n = 31; average age 25) or a postimplementation recording (n = 41; average age 26) with their provider. Both samples were racially and ethnically diverse.
Of the 15 healthcare providers, most were either nurse practitioners (47%) or counselors/ health educators (40%).
Each provider had between one and three audio recordings made of their discussions with patients about contraception before implementation of My Birth Control (an average of two recordings). Similarly, there were one to three recordings after tool implementation (an average of three recordings). A total of 70 recordings were analyzed, after excluding two postimplementation records from one provider, due to lack of discussion about other contraceptive alternatives.
Dr. Dehlendorf reports no relevant financial disclosures.