title: Women's Contraceptive Preference-Use Mismatch.
abstract: Family planning research has not adequately addressed women's preferences for different contraceptive methods and whether women's contraceptive experiences match their preferences.
  
  
  
  Data were drawn from the Women's Healthcare Experiences and Preferences Study, an Internet survey of 1,078 women aged 18-55 randomly sampled from a national probability panel. Survey items assessed women's preferences for contraceptive methods, match between methods preferred and used, and perceived reasons for mismatch. We estimated predictors of contraceptive preference with multinomial logistic regression models.
  
  
  
  Among women at risk for pregnancy who responded with their preferred method (n = 363), hormonal methods (non-LARC [long-acting reversible contraception]) were the most preferred method (34%), followed by no method (23%) and LARC (18%). Sociodemographic differences in contraception method preferences were noted (p-values <0.05), generally with minority, married, and older women having higher rates of preferring less effective methods, compared to their counterparts. Thirty-six percent of women reported preference-use mismatch, with the majority preferring more effective methods than those they were using. Rates of match between preferred and usual methods were highest for LARC (76%), hormonal (non-LARC) (65%), and no method (65%). The most common reasons for mismatch were cost/insurance (41%), lack of perceived/actual need (34%), and method-specific preference concerns (19%).
  
  
  
  While preference for effective contraception was common among this sample of women, we found substantial mismatch between preferred and usual methods, notably among women of lower socioeconomic status and women using less effective methods. Findings may have implications for patient-centered contraceptive interventions.
authors.affiliation: 1 University of Michigan Medical School , Ann Arbor, Michigan.
authors.forename: Katherine
authors.initials: K
authors.lastname: He
authors.affiliation: 2 Department of Obstetrics and Gynecology, Program on Women's Health Care Effectiveness Research, Institute for Healthcare Policy and Innovation, University of Michigan , Ann Arbor, Michigan.
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Dalton
authors.affiliation: 3 Undergraduate Research Opportunity Program, University of Michigan , Ann Arbor, Michigan.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Zochowski
authors.affiliation: 4 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University , Atlanta, Georgia .
authors.forename: Kelli Stidham
authors.initials: KS
authors.lastname: Hall
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D003271:Contraceptive Agents, Female / Q000627:therapeutic use; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008875:Middle Aged; D057240:Patient Preference; D018802:Patient-Centered Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female
keywords: contraception; health service delivery; patient preference; patient-centered; reproductive health; women's health