Asking the community: How can we improve contraceptive conversations between young women and their providers?
Awarded 2015
Community-Based Participatory Research Grants
Brooke Levandowski, PhD, MPA
State University of New York, Upstate Medical University

Objectives: Traditional contraceptive counseling has not been reliably associated with reducing unintended pregnancies, or led to increasing contraceptive uptake and continuation. This community based participatory research project aimed to identify appropriate interventions for both young women and contraceptive providers to support shared decision making within contraceptive conversations. Methods: Focus groups were conducted with nine groups of young women aged 15-24 years and five groups of contraceptive providers. Digital recordings of focus group discussions were transcribed, entered into NVivo software, coded, and analyzed using inductive coding and thematic analysis. Results: Young women felt being heard and providers felt empowering young women were critical elements for successful contraceptive conversations. Young women and health care professionals agreed that there were conversation elements that resulted in disconnect and patient misunderstanding. Young women and providers cited family openness and connectedness as well as school and community sexual education as factors that influence patient self-efficacy. Conclusion: Creating comfortable, safe spaces is important for empowering young women to ask clarification questions from their providers, particularly addressing the tension between urban myths and facts related to contraceptive side effects and efficacy. In turn, providers can practice feedback communication to ensure understanding. The maternal role in young women’s health decisions can both help and hinder contraception counseling. Providers can promote patient self-efficacy by counseling young women one-on-one. More information is needed on how to appropriately include maternal figures within contraceptive conversations. At provider offices, intervention opportunities could occur at intake, with providers, and within shared decision making.