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. 2021 Feb;103(2):97-102.
doi: 10.1016/j.contraception.2020.10.020. Epub 2020 Nov 5.

Patient and counselor satisfaction with structured contraceptive counseling by health center staff in federally qualified health centers

Bridget C Huysman  1 , Rachel Paul  1 , Adriana Nigaglioni Rivera  1 , Elana Tal  1 , Ragini Maddipati  1 , Tessa Madden  2
Affiliations

Patient and counselor satisfaction with structured contraceptive counseling by health center staff in federally qualified health centers

Bridget C Huysman et al. Contraception. 2021 Feb.

Abstract

Objectives: To characterize patient and counselor satisfaction with structured, tier-based contraceptive counseling provided by a nonclinician.

Study design: We conducted a planned secondary analysis of patient and counselor surveys from a study that enrolled women in 2 contraceptive care programs. All participants received structured contraceptive counseling from trained staff members. Women and counselors completed a confidential post-visit survey regarding satisfaction with counseling and medical mistrust. We used univariate and multivariable regressions to examine differences in high satisfaction with counseling (top score), perceived counselor influence, and perceived counselor judgment by participant characteristics.

Results: Nine hundred forty-two participants completed surveys; most reported they felt respected (100.0%), trusted the counseling information (99.5%), and that counseling helped them choose a contraceptive method (83.8%). Black race, high school education, public insurance, an income below the federal poverty level, and enrollment site were associated with high medical mistrust. Participants with high medical mistrust were less likely to be highly satisfied with counseling (adjusted relative risk (RR) 0.72; 95% confidence interval [CI] 0.63-0.82), more likely to perceive influence (RR 1.77; 95% CI 1.37-2.28), and more likely to perceive judgment (adjusted odds ratio 8.91; 95% CI 3.61-22.01). Mostly, counselors felt they were able to answer participant questions (98.8%), establish good rapport (95.9%), and that participants understood the information presented (98.0%).

Conclusions: Overall, participants were satisfied with tier-based contraceptive counseling delivered by nonclinician staff members. Those with high levels of medical mistrust were less likely to be satisfied. The majority of women found the information beneficial in contraceptive decision making.

Implications: Overall, women reported high satisfaction with tier-based contraceptive counseling delivered by a nonclinician in 3 federally qualified health centers. However, women with high medical mistrust were less likely to report high levels of satisfaction and more likely to report perceived influence or judgment from the counselor.

Keywords: Contraceptive counseling; Federally qualified health center; Medical mistrust; Patient satisfaction; Tier-based contraceptive counseling.

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Conflict of interest statement

Conflicts of Interest

Dr. Madden serves on a data safety monitoring board for phase 4 safety studies of Bayer contraceptive products. The other authors do not have any potential conflicts of interest to report.

Figures

Figure 1:
Figure 1:
Contraceptive counseling satisfaction score distributions by race and ethnicity
See this image and copyright information in PMC

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