Women’s values in contraceptive choice: a systematic review of relevant attributes included in decision aids

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Women can choose from a range of contraceptive methods that differ in important ways. Inadequate decision support may lead them to select a method that poorly fits their circumstances, leading to dissatisfaction, misuse, or nonuse. Decision support interventions, such as decision aids, may help women choose a method of contraception that best fits their personal circumstances. To guide future decision aid development, we aim to summarize the attributes of contraceptive methods included in available decision aids as well as surveys and interviews of women actively choosing a contraceptive method.

Methods

We conducted a systematic review to identify attributes of contraceptive methods that may be important to women when engaging in this decision making process. We performed a database search of MEDLINE/PubMed, Ovid EMBASE, OVID CENTRAL, Ovid PsycInfo, EBSCO CINAHL, Popline, and Scopus from 1985 until 2013 to identify decision aids, structured interviews and questionnaires reporting attributes of contraceptive options that are of importance to women. A free-text internet search was also performed to identify additional decision support tools. All articles and tools were reviewed in duplicate for inclusion, and a summary list of attributes was compiled.

Results

We included 20 surveys, 1 semistructured interview report and 19 decision aids, reporting 32 unique attributes. While some attributes were consistently included in surveys/interviews and decision aids, several were included more often in decision aids as opposed to surveys/interviews (e.g., STI prevention, noncontraceptive benefits, how the method is used, requirement of a healthcare provider), and vice versa (e.g., a woman’s vicarious experience with contraceptive methods). Key attributes mentioned in both surveys/interviews and decision aids include efficacy (29 total mentioned) and side effects/health risks (28 total mentioned). While a limited number of decision support tools were formally evaluated, many were not rigorously studied.

Conclusions

Many attributes were identified as potentially important to women choosing a method of contraception, but these were inconsistently included in the reviewed resources. Formal evaluation of decision support tools for contraceptive choice and involvement of users in the development process may lead to more user-centered design and implementation.

Related collections

Most cited references 33

Record: found
Abstract: found
Article: not found

An integrative model of shared decision making in medical encounters.

Gregory Makoul, Marla L. Clayman (2006)

Given the fluidity with which the term shared decision making (SDM) is used in teaching, assessment and research, we conducted a focused and systematic review of articles that specifically address SDM to determine the range of conceptual definitions. In April 2005, we ran a Pubmed (Medline) search to identify articles published through 31 December 2003 with the words shared decision making in the title or abstract. The search yielded 681 citations, 342 of which were about SDM in the context of physician-patient encounters and published in English. We read and reviewed the full text of all 342 articles, and got any non-redundant references to SDM, which yielded an additional 76 articles. Of the 418 articles examined, 161 (38.5%) had a conceptual definition of SDM. We identified 31 separate concepts used to explicate SDM, but only "patient values/preferences" (67.1%) and "options" (50.9%) appeared in more than half the 161 definitions. Relatively few articles explicitly recognized and integrated previous work. Our review reveals that there is no shared definition of SDM. We propose a definition that integrates the extant literature base and outlines essential elements that must be present for patients and providers to engage in the process of SDM. The integrative definition of SDM is intended to provide a useful foundation for describing and operationalizing SDM in further research.

0 comments Cited 417 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Women's preferences for contraceptive counseling and decision making.

Christine Dehlendorf, Kevin Grumbach, Julie Levy … (2013)

Little is known about what women value in their interactions with family planning providers and in decision making about contraception. We conducted semistructured interviews with 42 black, white and Latina patients. Transcripts were coded using modified grounded theory. While women wanted control over the ultimate selection of a method, most also wanted their provider to participate in the decision-making process in a way that emphasized the women's values and preferences. Women desired an intimate, friend-like relationship with their providers and also wanted to receive comprehensive information about options, particularly about side effects. More black and Spanish-speaking Latinas, as compared to whites and English-speaking Latinas, felt that providers should only share their opinion if it is elicited by a patient or if they make their rationale clear to the patient. While, in the absence of medical contraindications, decision making about contraception has often been conceptualized as a woman's autonomous decision, our data indicate that providers of contraceptive counseling can participate in the decision-making process within limits. Differences in preferences seen by race/ethnicity illustrate one example of the importance of individualizing counseling to match women's preferences. Copyright © 2013 Elsevier Inc. All rights reserved.

0 comments Cited 79 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Health decision aids to facilitate shared decision making in office practice.

Michael Barry (2002)

For medical decisions with more than one reasonable option, patient participation in decision making is often necessary to optimally match management decisions with patient preferences. Health decision aids are designed to facilitate shared decision making by helping patients and their physicians choose among reasonable clinical options. Although these aids vary in content, common denominators are the presentation of more than one reasonable strategy for a clinical management question and a description of the possible outcomes of the various options. Although the number of published randomized trials assessing the impact of health decision aids on the quality of medical decisions is limited (but growing), various types of decision aids do generally appear to inform patients about their treatment options better than "usual care" can. Little evidence is available to determine whether one type of decision aid is optimal, but more complicated programs seem to have larger effects. The cost-effectiveness of decision aids has not been studied, although it is enticing to think that the pattern of more conservative decisions by users of some decision aids could reduce medical care costs in a manner that is dictated by patient preferences.

0 comments Cited 31 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): BMC Womens Health

Journal ID (iso-abbrev): BMC Womens Health

Title: BMC Women's Health

Publisher: BioMed Central

ISSN (Electronic): 1472-6874

Publication date Collection: 2014

Publication date (Electronic): 13 February 2014

Volume: 14

Page: 28

Affiliations

[1 ]Mayo Medical School, 200 First Street Southwest, Rochester, MN 55905, USA

[2 ]Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA

[3 ]Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA

[4 ]Division of Endocrinology, Department of Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA

[5 ]Center for the Science of Healthcare Delivery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA

[6 ]Department of Family Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA

[7 ]Mayo Clinic Libraries, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA

[8 ]Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA

Article

Publisher ID: 1472-6874-14-28

DOI: 10.1186/1472-6874-14-28

PMC ID: 3932035

PubMed ID: 24524562

SO-VID: e0d1f82b-c953-4256-83e6-d6e5a4968f5d

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Women’s values in contraceptive choice: a systematic review of relevant attributes included in decision aids

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

Bacterial vaginosis and biofilm

Most cited references 33

An integrative model of shared decision making in medical encounters.

Women's preferences for contraceptive counseling and decision making.

Health decision aids to facilitate shared decision making in office practice.

Author and article information

Journal

Affiliations

Article

History

Categories

Comments

Comment on this article

Similar content 141

Cited by 25

Most referenced authors 251