Reproductive health service preferences and perceptions of quality among low-income women: racial, ethnic and language group differences.
BACKGROUND
Eliminating racial and ethnic disparities in health care is an important national priority. Despite substantial research documenting such disparities, this topic has received limited attention in the reproductive health field.


METHODS
Logistic regression was used to test for group differences in three service delivery preferences and five service quality perceptions among a nationally representative sample of 1,741 low-income black, Latina and white women aged 18-34; the data were collected in 1995 and represent the most recent data available for looking at these issues.


RESULTS
English-speaking Latinas and Spanish-speaking Latinas were more likely than whites to prefer a female clinician at their visits (odds ratios, 1.8 and 3.6, respectively) and to highly value clinician continuity (1.7 and 2.2). English-speaking Latinas and blacks were more likely than whites to prefer receiving reproductive health care at a site delivering general health care (1.5 and 1.6). Both groups of Latinas were less likely than whites to give the facility environment or the patient-centeredness at their most recent reproductive health visit the highest rating (0.3-0.5). Blacks were more likely than whites to report ever having been pressured by a clinician to use contraceptives (2.3).


CONCLUSIONS
Efforts to reduce racial, ethnic and language group differences in clients' perceptions of reproductive health service quality should focus on improving client-clinician communication, the service environment and contraceptive counseling. Future research should continue to assess group differences and try to determine their underlying causes.
Becker
Davida
D
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA. becker@obgyn.ucsf.edu
Tsui
Amy O
AO
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D003270:Contraceptive Agents; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D007802:Language; D016015:Logistic Models; D017060:Patient Satisfaction / Q000208:ethnology*; D010817:Physician-Patient Relations; D011203:Poverty; D011320:Primary Health Care; D011787:Quality of Health Care; D034121:Reproductive Health Services / Q000592:standards*; D012938:Social Perception; D014481:United States; D044465:White People / Q000523:psychology; D055815:Young Adult
D003270:Contraceptive Agents