A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making

Abstract

Objectives: Barriers to the provision of patient-centered contraceptive counseling include time limitations, frequent misconceptions and misinformation about methods among patients, and the availability of numerous contraceptive options, which increases the complexity of contraceptive decision making. Decision support tools are interventions designed to facilitate quality decision making in preference-sensitive decisions. We evaluated the impact of a contraceptive decision support tool, My Birth Control, on providers' experience with contraceptive counseling.

Study design: We interviewed 15 providers who participated in the intervention arm of a cluster randomized controlled trial of My Birth Control to obtain their impressions of their patients' interactions with the tool. We analyzed the interviews using thematic analysis, compared appointment lengths of patients in each arm (n=749) and assessed provider burnout in each arm (n=28).

Results: Providers reported that incorporating My Birth Control into their practice helped them allocate time more efficiently, enabling them to hone in on patients' areas of interest. They also reported that patients who interacted with the tool appeared more informed about contraception options and features, and took a more active role in method selection. All providers described using the tool as acceptable and feasible, and indicated they would like to incorporate it into their practice. There was no difference in provider burnout scores comparing before and after the trial of My Birth Control.

Conclusion: Providers had a positive impression of the impact of My Birth Control on contraceptive counseling, including the quality of counseling, and perceived the tool to be a feasible intervention to use in the clinical setting.

Implications: Family planning clinics should consider incorporating My Birth Control into their clinical services as a means of improving contraceptive care and provider experience of counseling.

Keywords: Contraception; Contraceptive counseling; Family planning; Patient-centered care, decision support; Shared decision making.