Evidence map›Paper›PMID 37216964›Full record

ArticlePerspectives on sexual and reproductive health2023

"She should support me, she's my doctor:" Patient perceptions of agency in contraceptive decision-making in the clinical encounter in Northern California.

Lavanya Rao, Corinne H Rocca, Isabel Muñoz, Brittany D Chambers, Sangita Devaskar, Ifeyinwa V Asiodu, Lisa Stern, Maya Blum, Alison B Comfort, Cynthia C Harper

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Perspectives on sexual and reproductive health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 14% of its field
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, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
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

10 authors at 5 institutions in 1 country.

Lavanya RaoDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
Corinne H RoccaDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
Isabel MuñozDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
Brittany D ChambersDepartment of Human Ecology, University of California, Davis, School of Agricultural and Environmental Sciences, Davis, California, USA.
Sangita DevaskarPlanned Parenthood Northern California, Santa Rosa, California, USA.
Ifeyinwa V AsioduDepartment of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, California, USA.
Lisa SternCoalition to Expand Contraceptive Access (CECA), San Francisco, California, USA.
Maya BlumDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
Alison B ComfortDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
Cynthia C HarperDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
University of California, San Francisco · USUniversity of California System · USPlanned Parenthood · USRafiki Coalition · USUniversity of California, Davis · US

Funding

UCSF/Kaiser-DOR Program for Developing Independent Women's Health ResearchersK12HD052163 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ADLER, NANCY E, BRINDIS, CLAIRE D. · 2005 to 2023
$9.3M
University of California, San Francisco/Kaiser Permanente Northern California Division of Research Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) K12 ProgramK12AR084219 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Monica Gandhi, CYNTHIA C HARPER · 2023 to 2026
$3.1M
Understanding individual- and social network-level factors affecting infant HIV testing to design social network interventions to increase testing of HIV-exposed infantsK01HD105521 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COMFORT, ALISON B · 2021 to 2025
$722k
NIAMS NIH HHS K12 AR084219NICHD NIH HHS K01 HD105521NICHD NIH HHS K12 HD052163
6 · The paper itself

Abstract

introductionAgency in contraceptive decision-making is an essential aspect of reproductive autonomy. We conducted qualitative research to investigate what agency means to patients seeking contraceptive care to inform the development of a validated measure of this construct. METHODOLOGY: We held four focus group discussions and seven interviews with sexually-active individuals assigned female at birth, ages 16-29 years, recruited from reproductive health clinics in Northern California. We explored experiences in contraceptive decision-making during the clinic visit. We coded data in ATLAS.ti and by hand, compared codes across three coders, and used thematic analysis to identify salient themes.

resultsThe sample mean age was 21 years, with 17% of participants identifying as Asian, 23% as Black, 27% as Latinx, 17% as Multiracial/other, and 27% as white. Overall, participants reported active and engaged decision-making in their recent contraceptive visit but noted experiences that had undermined their agency in the past. They described how non-judgmental care allowed them to communicate openly, affirming their ability to make their own decisions. However, several mentioned how unexpected contraceptive side effects after the visit had reduced their sense of agency over their decision in retrospect. Several participants, including those who identified as Black, Latinx, and/or Asian, described prior experiences where pressure to use a contraceptive method had undermined their agency and where they had switched providers to regain agency over their contraceptive decisions. DISCUSSION: Most participants were aware of their agency during contraceptive visits and how it varied in different experiences with providers and the healthcare system. Patient perspectives can help to inform measurement development and ultimately the delivery of care that supports contraceptive agency.

Indexed as

Contraceptive AgentsPhysiciansAdolescentAdultCaliforniaContraceptionContraceptive DevicesFemaleHumansYoung AdultContraceptive Agentscontraceptive agencycontraceptive decision-makingreproductive autonomy

Identifiers

PMID37216964
PMCPMC10537387
OpenAlexW4377288229

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.