Evidence map›Paper›PMID 36535412›Full record

ArticleContraception2023

Provider perspectives on patient-centered contraceptive counseling for Latinas in Baltimore, MD.

Diana N Carvajal, Kristin G Bevilacqua, Martina T Caldwell, Ruth E Zambrana

Abstract read
In one paragraph

Article in Contraception, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Diana N CarvajalDepartment of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, United States. Electronic address: dcarvajal@som.umaryland.edu.
Kristin G BevilacquaDepartment of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Martina T CaldwellDepartment of Emergency Medicine, Henry Ford Health System, Detroit, MI, United States.
Ruth E ZambranaHarriet Tubman Department of Women, Gender and Sexuality Studies, University of Maryland, College Park, MD, United States.

Funding

Development and Testing of a Point-of-Care Shared Decision-Making Tool for ProvidersK23HD096056 · NICHD · UNIVERSITY OF MARYLAND BALTIMORE · PI CARVAJAL, DIANA N · 2019 to 2023
$812k
NICHD NIH HHS K23 HD096056
6 · The paper itself

Abstract

objectivesTo explore: 1) provider narratives of their contraceptive counseling practices with Latina patients within the context of patient-centered care (PCC); and 2) provider perceptions about the barriers to the provision of patient-centered contraceptive counseling in general and more specifically, with Latina patients in Baltimore, MD. STUDY

designWe conducted 25 semistructured qualitative interviews with physicians  and nurse practitioners from four specialties who provide contraceptive care to Latinas in Baltimore, MD. We analyzed data using directed content analysis. We discuss findings with attention to major constructs of PCC, applying a reproductive justice framework.

resultsProviders described a contraceptive counseling approach focused on pregnancy prevention as the primary goal. Most respondents used a tiered-effectiveness approach, even while noting the importance of PCC. Providers noted health system barriers to PCC, including time constraints and insurance status. Provider-reported patient-attributed barriers included low patient education/health literacy, culturally-attributed misconceptions about contraception, and language discordance.

conclusionProviders described knowledge of and intention to practice PCC but had limited integration of it in their own counseling with Latinas. Responses suggest tension between an expressed desire to provide PCC and paternalistic counseling paradigms that prioritize pregnancy prevention over patient preferences. Inequitable health system barriers also interfere with true implementation of contraceptive PCC. IMPLICATIONS: Translating contraceptive PCC into practice, especially for marginalized communities, is paramount. Training should teach clinicians to recognize systems of structural inequity and discrimination that have informed approaches to counseling but are not reflective of PCC. Institutional policies must address health system barriers that also hamper PCC.

Indexed as

ContraceptionContraceptive AgentsBaltimoreCounselingFamily Planning ServicesFemaleHispanic or LatinoHumansPatient-Centered CarePregnancyContraceptive AgentsContraceptive counselingLatinasLatinxPatient-centered careReproductive justice

Identifiers

PMID36535412
PMCPMC9957913

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.