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Understanding and tailoring pregnancy intention screening tools through community-based participatory research (CBPR) with Latina women

Samantha Garbers, Columbia University

Project abstract

Screening women of reproductive age for pregnancy intention as a routine part of primary care has been recommended by professional organizations as a way to reduce the unintended pregnancy rate and improve birth outcomes through a prevention-oriented approach. However, increasing attention to reproductive justice, cultural relevance, and patient-centered outcomes has raised questions about the effectiveness of such screening and its impact on patient decision-making. The ways healthcare providers screen patients may inhibit the patient-provider communication necessary to support reproductive decision-making, specifically contraceptive choice and use. Current screening approaches may not accurately reflect patients' experiences or nuanced views about pregnancy, or sufficiently acknowledge the variety of linguistic, cultural, and religious backgrounds of women screened for pregnancy intentions, particularly Latinas served by community health centers. The specific aims of the proposed research are to: (1) Establish a collaborative partnership to engage community members in a research initiative; (2) Explore qualitatively the cultural interpretations of patients and providers of existing pregnancy intention screening practices; (3) Describe how, when, and with whom Latinas desire to discuss pregnancy intention during primary care visits; and (4) Generate specific recommendations for implementing improved screening practices. This CBPR project brings together researchers and community members to articulate research questions, develop interview guides, and train community members to interview providers and Latina women aged 18-44 at a community health center in New York City. The community and research teams will jointly conduct qualitative analyses and develop recommendations. This project includes a rigorous process evaluation of community engagement


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