title: Women's perceptions and reasons for choosing the pill, patch, or ring in the CHOICE study: a cross-sectional survey of contraceptive method selection after counseling.
abstract: BACKGROUND
  The European CHOICE study was a cross-sectional survey that evaluated women's combined hormonal contraceptive choices before and after contraceptive counseling in Austria, Belgium, Czech Republic and Slovakia, the Netherlands, Poland, Sweden, Switzerland, Israel, Russia, and Ukraine. The changes in method selection before and after counseling were reported previously. In this paper we present the reasons given by the 18,787 participating women for selecting their contraceptive method of choice, as well as their perceptions about the contraceptive pill, patch, and ring after counseling.
  
  
  METHODS
  Women with an interest in a combined hormonal contraceptive method (pill, patch, or ring) were counseled using a standardized counseling leaflet. The women completed questionnaires, which included questions on why they had selected a particular method of contraception, and the extent to which they agreed with statements about the attributes of the pill, patch, and ring. The results for each country were compared with the percentages for all countries combined by using a binomial regression model. Multiple logistic regression models were used to investigate the extent to which the probability of choosing a method was related to prespecified aspects (i.e. perceptions) of each contraceptive method.
  
  
  RESULTS
  'Easy to use', 'convenience', and 'regular menstrual bleeding' were important selection criteria. 'Nondaily administration' was one of the main reasons women selected the patch or ring. 'Daily use' and 'will forget to take it' were the primary reasons for not selecting the pill, while the main reasons for not choosing the patch included 'not discrete, visible' and 'can fall off'. In a small number of instances, the ring was rejected because some women don't like to use a 'foreign body'. Women's perceptions influenced their contraceptive decisions: positive perceptions about a method increased the likelihood that a woman would select it. After counseling, many women associated the pill with forgetfulness, and many still did not know about the patch or ring's key attributes. Women's knowledge about a particular method was generally greater if they had chosen it.
  
  
  CONCLUSIONS
  To support informed contraceptive decision-making, healthcare professionals should realize that a woman's view of a method's ease of use is more important than perceived efficacy, tolerability, health benefits, or risks.
authors: Medical University of Vienna, Vienna, Austria. christian.egarter@meduniwien.ac.at
authors: Christian
authors: C
authors: Egarter
authors: Brigitte
authors: B
authors: Frey Tirri
authors: Johannes
authors: J
authors: Bitzer
authors: Vyacheslav
authors: V
authors: Kaminskyy
authors: Björn J
authors: BJ
authors: Oddens
authors: Vera
authors: V
authors: Prilepskaya
authors: Arie
authors: A
authors: Yeshaya
authors: Maya
authors: M
authors: Marintcheva-Petrova
authors: Steven
authors: S
authors: Weyers
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003267:Contraception / Q000523:psychology* / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000523:psychology* / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration; D011369:Professional-Patient Relations; D012959:Socioeconomic Factors; D016387:Women's Health / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female