How can Primary Care Physicians Best Support Contraceptive Decision Making? A Qualitative Study Exploring the Perspectives of Baltimore Latinas.
U.S. Latinas experience disproportionately high rates of unintended pregnancy and low rates of consistent contraception use. Not well known are Latinas' perspectives about how primary care physicians (PCPs) might facilitate or deter contraceptive decision making. The theory of planned behavior has been used previously to explain contraceptive behaviors. This study used the theory of planned behavior as a guide to help describe Latinas' perspectives regarding specific factors that influence their contraceptive decision making and to describe their perspectives about the role of PCPs in the decision making.



We conducted focus groups (n = 3) and interviews (n = 8) of Latinas ages 15 to 24 years, recruited from urban primary care sites in Baltimore, Maryland. Concepts from the theory of planned behavior were used to develop a coding scheme and guide identification of themes.



Sixteen Latinas participated; all were immigrants.



The desire to avoid unintended pregnancy is dominant and, not surprisingly, is the main driver of contraceptive intentions. The role of PCPs in contraceptive decision making is to build strong patient relationships through heightened communication and trust. PCPs should develop trust and foster communication by using a shared decision-making approach in contraceptive counseling. Religious norms rarely operate as barriers to contraceptive use, yet positive reinforcement from family, friends, and schools is viewed as supportive.



For this group of young, immigrant Latinas, there is a pervasive desire for effective communication and trusting relationships with PCPs. Findings suggest that providers can facilitate contraceptive decision making for this population by using a shared decision-making approach to contraceptive counseling.
Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: dcarvajal@som.umaryland.edu.
Diana N
DN
Carvajal
University of Maryland School of Social Work, Baltimore, Maryland.
Deborah
D
Gioia
Ponce School of Medicine, Ponce, Puerto Rico.
Estefania Rivera
ER
Mudafort
Baltimore Medical System, Baltimore, Maryland.
Pamela Bohrer
PB
Brown
Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
Beth
B
Barnet
D000293:Adolescent; D015142:Baltimore; D003267:Contraception; D065246:Culturally Competent Care; D003657:Decision Making; D005193:Family Planning Services; D005260:Female; D017144:Focus Groups; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D010819:Physician's Role; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D036301:Qualitative Research; D063505:Racism; D055815:Young Adult