title: Reproductive Life Planning in Primary Care: A Qualitative Study of Women Veterans' Perceptions.
abstract: BACKGROUND
  Women veterans using Veterans Administration (VA) health care have high rates of medical and mental health comorbidities, placing them at increased risk of poor outcomes from unplanned pregnancy. Reproductive life planning is a strategy recommended by the U.S. Centers of Disease Control and Prevention that could promote healthy pregnancies and reduce unplanned pregnancy in the VA. However, no data exist on women veterans' perceptions of reproductive life planning discussions.
  
  
  METHODS
  We trained six VA primary care physicians at two VA Women's Health Clinics to conduct reproductive life planning discussions with veterans aged 18 to 44 during primary care visits. After the visit, we performed semistructured telephone interviews with consenting veterans to explore perceptions of 1) reproductive life planning content and 2) provider-patient communication in reproductive life planning discussions. Interviews were audiorecorded, transcribed, and analyzed using content analysis.
  
  
  RESULTS
  We interviewed 27 veterans with a mean age of 31 years (range, 22-42). Women veterans perceived generally reproductive life planning discussions as important opportunities to discuss reproductive goals with providers and to obtain new and relevant information about contraception, planning healthy pregnancies, and available VA reproductive health services. Perceptions of reproductive life planning content were influenced by women's pregnancy intentions. Perceptions related to provider-patient communication included preferences for provider-initiated discussions and nonjudgmental counseling that incorporates patients' values and preferences.
  
  
  CONCLUSIONS
  Women veterans perceived reproductive life planning as valuable and important to their health. Reproductive life planning has the potential to enhance patient-centered delivery of reproductive health services in VA primary care.
authors.affiliation: Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington; Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington. Electronic address: lisa.callegari@va.gov.
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Callegari
authors.affiliation: Center for Health Equity, Research, and Promotion, VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
authors.affiliation: Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington; Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington.
authors.forename: Gayle E
authors.initials: GE
authors.lastname: Reiber
authors.affiliation: Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington; Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Karin M
authors.initials: KM
authors.lastname: Nelson
authors.affiliation: VA Office of Patient Care Services, Women's Health Services, Washington, DC; Department of Obstetrics and Gynecology, New York University Langone School of Medicine, New York, New York.
authors.forename: Laurie
authors.initials: L
authors.lastname: Zephyrin
authors.affiliation: Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington.
authors.forename: George G
authors.initials: GG
authors.lastname: Sayre
authors.affiliation: Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington; VA Office of Patient Care Services, Women's Health Services, Washington, DC.
authors.forename: Jodie G
authors.initials: JG
authors.lastname: Katon
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006787:Hospitals, Veterans / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D057240:Patient Preference; D010465:Perception; D010817:Physician-Patient Relations; D011320:Primary Health Care; D036301:Qualitative Research; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D016387:Women's Health; D014932:Women's Health Services / Q000592:standards / Q000706:statistics & numerical data*