Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status

Recommendations by health care providers have been found to vary by patient race/ethnicity and socioeconomic status and may contribute to health disparities. This study investigated the effect of these factors on recommendations for contraception. One of 18 videos depicting patients of varying socio...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology Vol. 203; no. 4; pp. 319.e1 - 319.e8
Main Authors: Dehlendorf, Christine, Ruskin, Rachel, Grumbach, Kevin, Vittinghoff, Eric, Bibbins-Domingo, Kirsten, Schillinger, Dean, Steinauer, Jody
Format: Journal Article
Language:English
Published: New York, NY Mosby, Inc 01.10.2010
Elsevier
Subjects:
Attitude of Health Personnel
Biological and medical sciences
Continental Population Groups
Contraceptive Agents, Female - therapeutic use
contraceptive counseling
family planning
Female
Gynecology. Andrology. Obstetrics
health disparities
Humans
intrauterine contraception
Intrauterine Devices, Medicated
Levonorgestrel - therapeutic use
Male
Medical sciences
Middle Aged
Obstetrics and Gynecology
Risk Factors
Social Class
Videotape Recording
intrauterine contraception
family planning
health disparities
contraceptive counseling
Human
Randomization
Socioeconomic status
Uterus
Gynecology
Race
Clinical trial
Contraception
Epidemiology
Obstetrics
Recommendation
ISSN:0002-9378, 1097-6868, 1097-6868
Online Access:Get full text
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Summary:Recommendations by health care providers have been found to vary by patient race/ethnicity and socioeconomic status and may contribute to health disparities. This study investigated the effect of these factors on recommendations for contraception. One of 18 videos depicting patients of varying sociodemographic characteristics was shown to each of 524 health care providers. Providers indicated whether they would recommend levonorgestrel intrauterine contraception to the patient shown in the video. Low socioeconomic status whites were less likely to have intrauterine contraception recommended than high socioeconomic status whites (odds ratio [OR], 0.20; 95% confidence interval [CI], 0.06–0.69); whereas, socioeconomic status had no significant effect among Latinas and blacks. By race/ethnicity, low socioeconomic status Latinas and blacks were more likely to have intrauterine contraception recommended than low socioeconomic status whites (OR, 3.4; and 95% CI, 1.1–10.2 and OR, 3.1; 95% CI, 1.0–9.6, respectively), with no effect of race/ethnicity for high socioeconomic status patients. Providers may have biases about intrauterine contraception or make assumptions about its use based on patient race/ethnicity and socioeconomic status.
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Study Location: Chicago, IL; Las Vegas, NV; New Orleans, LA
ISSN:0002-9378
1097-6868
1097-6868
DOI:10.1016/j.ajog.2010.05.009