East Tennessee State University College of Public Health’s Center for Applied Research and Evaluation in Women’s Health has published in Women’s Health Reports. The article, Multilevel Influences on Providers' Delivery of Contraceptive Services: A Qualitative Thematic Analysis, offers an in-depth examination of influences on providers' delivery of contraceptive services across multiple primary care specialties and practice settings.
Dr. Abbey Mann of Lafayette College is lead author of the article. Co-authors include Amal Khoury, Paezha McCartt, Michael Smith, Nathan Hale, Kate Beatty, and Leigh Johnson of CARE Women’s Health.
Reproductive health care, including access to the full range of contraceptive services, is fundamental to people’s health and well-being. Modern contraception is safe and effective, allowing reproductive life planning and preventing unintended pregnancy. Primary care providers play a key role in contraceptive counseling and provision. Provider practices and quality of care are a major driver of contraceptive use in the population and ultimately of reproductive health outcomes. Access to a full range of contraceptive services is essential for quality health care. Contraceptive provision practices of primary care providers play an important role in patients' decision-making about their reproductive health care. Understanding the multilevel factors influencing contraceptive care delivery in primary care settings is critical for advancing quality care.
In this study, 24 in-depth face-to-face interviews were conducted with primary care providers, including family physicians, gynecologists, pediatricians, and nurse practitioners from academic settings, private practices, and health centers. Interviews were transcribed and analyzed thematically.
Major themes that emerged from the qualitative analysis identified key multi-level influences provision of contraception, including factors at the structural and policy, community, organizational, individual provider, s, and individual patient levels. . Providers also discussed the sources they access for evidence-based contraception counseling information.
A diverse set of providers described a complex system in which multiple concentric ecological contexts both positively and negatively influence the ways in which they provide contraceptive services to their patients. To close the gaps in contraceptive service delivery, it is important to recognize that both barriers and facilitators to person-centered contraceptive counseling exist simultaneously across multiple ecological contexts.