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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Shared Decision-Making for Contraceptive Counseling Among Women Seeking Services at Safety Net Clinics in South Carolina and Alabama

Nyarambi, Dumisa M 01 August 2021 (has links)
Shared decision-making (SDM) for contraceptive counseling and method initiation is a hallmark of patient-centered care; SDM is associated with patient satisfaction, method continuation, and the prevention of pregnancy and short inter-pregnancy intervals. To achieve a high-quality experience for women Person-centered approach to counseling is the preferred approach to achieve SDM. Demographic factors and women’s perceptions of their providers have been linked to decision-making. Literature is lacking on SDM practices in safety net clinics, particularly in local health departments. Exploring these constructs is important to inform practices and policies for family planning. This research aimed to examine: 1) the influence of sociodemographic factors on SDM; 2) the influence of SDM on contraceptive method choice; and 3) the effect that women’s perceptions of their providers might have on SDM and associated contraceptive method choice, among non-white women in South Carolina and Alabama. Secondary data were from a longitudinal study that surveyed women of reproductive age (16 to 44 years) from the two states. The data used for this research were collected from non-white women between October 2018 and September 2020 as part of a larger evaluation effort. Bivariate and multinomial analyses were conducted to assess associations and relationships. In Study 1, significant differences in SDM were observed for income and age, with younger women and lower income women having increased odds of engaging in SDM compared to older and higher income counterparts. In Study 2, multinomial analysis indicated that, compared to those who maintained autonomy over their decision, those whose decisions were shared and provider-driven had higher odds of choosing a short-acting method over a less effective method (OR = 1.608 and OR = 2.314, respectively). In Study 3, associations between SDM and women’s perceptions of providers were observed. Compared to those who maintained decision-making autonomy and had positive perceptions of providers, those who engaged in SDM and those whose decisions were least autonomous were more likely to choose a short-acting method over other, less effective contraceptive methods. There is need to further examine whether SDM is underutilized in these settings.

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