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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| Vydáno v: | American journal of obstetrics and gynecology Ročník 203; číslo 4; s. 319.e1 - 319.e8 |
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| Hlavní autoři: | , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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New York, NY
Mosby, Inc
01.10.2010
Elsevier |
| Témata: | |
| ISSN: | 0002-9378, 1097-6868, 1097-6868 |
| On-line přístup: | Získat plný text |
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| Abstract | 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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| AbstractList | 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. 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.OBJECTIVERecommendations 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.STUDY DESIGNOne 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.RESULTSLow 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.CONCLUSIONProviders may have biases about intrauterine contraception or make assumptions about its use based on patient race/ethnicity and socioeconomic status. Objective 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. Study Design 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. Results 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. Conclusion Providers may have biases about intrauterine contraception or make assumptions about its use based on patient race/ethnicity and socioeconomic status. |
| Author | Steinauer, Jody Grumbach, Kevin Vittinghoff, Eric Schillinger, Dean Ruskin, Rachel Dehlendorf, Christine Bibbins-Domingo, Kirsten |
| AuthorAffiliation | Department of Family and Community Medicine, UCSF; 995 Potrero Avenue Ward 83, San Francisco, CA 94110 Department of Medicine, UCSF; 1001 Potrero Avenue Ward 13; San Francisco, CA. 94143 – 1364 Department of Epidemiology and Biostatistics, UCSF; 185 Berry Street, Suite 5700; San Francisco, CA 94107 Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, UCSF; 1001 Potrero Avenue, San Francisco, CA 94110 |
| AuthorAffiliation_xml | – name: Department of Medicine, UCSF; 1001 Potrero Avenue Ward 13; San Francisco, CA. 94143 – 1364 – name: Department of Family and Community Medicine, UCSF; 995 Potrero Avenue Ward 83, San Francisco, CA 94110 – name: Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, UCSF; 1001 Potrero Avenue, San Francisco, CA 94110 – name: Department of Epidemiology and Biostatistics, UCSF; 185 Berry Street, Suite 5700; San Francisco, CA 94107 |
| Author_xml | – sequence: 1 givenname: Christine surname: Dehlendorf fullname: Dehlendorf, Christine organization: Department of Family and Community Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA – sequence: 2 givenname: Rachel surname: Ruskin fullname: Ruskin, Rachel organization: Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA – sequence: 3 givenname: Kevin surname: Grumbach fullname: Grumbach, Kevin organization: Department of Family and Community Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA – sequence: 4 givenname: Eric surname: Vittinghoff fullname: Vittinghoff, Eric organization: Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA – sequence: 5 givenname: Kirsten surname: Bibbins-Domingo fullname: Bibbins-Domingo, Kirsten organization: Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA – sequence: 6 givenname: Dean surname: Schillinger fullname: Schillinger, Dean organization: Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA – sequence: 7 givenname: Jody surname: Steinauer fullname: Steinauer, Jody organization: Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23327970$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/20598282$$D View this record in MEDLINE/PubMed |
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| Keywords | intrauterine contraception family planning health disparities contraceptive counseling Human Randomization Socioeconomic status Uterus Gynecology Race Clinical trial Contraception Epidemiology Obstetrics Recommendation |
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| SubjectTerms | 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 |
| Title | Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status |
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