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A direct observation study of provider-patient communication about contraception: How does race affect communication, and how does communication affect contraception use?

Christine Dehlendorf, University of California, San Francisco, 2008
See also executive summary.

Project abstract

Minority women are at a higher risk of experiencing unintended pregnancies than are White women. Differences in the use of contraception have been documented as one factor contributing to disparities in unintended pregnancy but are not well understood and have not been investigated from the perspective of health care disparities. Research in other areas indicates that differences in health outcomes by race/ethnicity are not due solely to access to care or socioeconomic status.

While differences in patient preferences likely explains some of the disparities remaining after the removal of these factors, evidence also exists that differences in the care provided by health care providers also contribute. In this research proposal, we propose to investigate health care disparities in contraception by using direct observation to study how providers communicate with patients about contraception. This study will provide information about components of communication in which disparities by race/ethnicity are evident, as well as supply data about which aspects of communication impact use of contraception.

As contraception is a preference-sensitive decision and raises issues of sexuality, we hypothesize that in this context, variations in provider-patient communication by race/ethnicity are pronounced and may be one cause of disparities in contraceptive use. This research will apply the growing understanding of health care disparities and provider-patient communication to the area of contraception and will provide the background necessary to develop an intervention to improve contraceptive use and decrease unintended pregnancy in diverse populations.


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