Racial and ethnic disparities in contraceptive knowledge among women veterans in the ECUUN study.
OBJECTIVE
To assess whether racial/ethnic disparities in contraceptive knowledge observed in the general US population are also seen among women Veterans served by the Veterans Affairs (VA) healthcare system.


METHODS
We analyzed data from a national telephone survey of 2302 women Veterans aged 18-44 who had received care within VA in the prior 12 months. Twenty survey items assessed women's knowledge about various contraceptive methods. Multivariable logistic regression was used to examine racial/ethnic variation in contraceptive knowledge items, adjusting for age, marital status, education, income, parity, and branch of military service.


RESULTS
Contraceptive knowledge was low among all participants, but black and Hispanic women had lower knowledge scores than whites in almost all knowledge domains. Compared to white women, black women were significantly less likely to answer correctly 15 of the 20 knowledge items, with the greatest adjusted difference observed in the item assessing knowledge about the reversibility of tubal sterilization (adjusted percentage point difference (PPD): -23.0; 95% CI: -27.8, -18.3). Compared to white women, Hispanic women were significantly less likely to answer correctly 11 of the 20 knowledge items, with the greatest adjusted difference also in the item assessing tubal sterilization reversibility (PPD: -13.1; 95% CI: -19.5, -6.6).


CONCLUSIONS
Contraceptive knowledge among women Veterans served by VA is suboptimal, especially among racial/ethnic minority women. Improving women's knowledge about important aspects of available contraceptive methods may help women better select and effectively use contraception.


CONCLUSIONS
Providers in the VA healthcare system should assess and address contraceptive knowledge gaps as part of high-quality, patient-centered reproductive health care.
Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, University Drive (151C), Pittsburgh, PA 15240.
Elian
E
Rosenfeld
Health Services Research and Development, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108; Department of Obstetrics & Gynecology, University of Washington School of Medicine, Box 356460, Seattle, WA 98195-6460.
Lisa S
LS
Callegari
Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, University Drive (151C), Pittsburgh, PA 15240.
Florentina E
FE
Sileanu
Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, University Drive (151C), Pittsburgh, PA 15240.
Xinhua
X
Zhao
Division of General Internal Medicine, University of California, Davis School of Medicine, 4150 V Street, Suite 3100, Sacramento, CA 95817.
E Bimla
EB
Schwarz
Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, University Drive (151C), Pittsburgh, PA 15240; Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, 130 De Soto St., Pittsburgh, PA 15261.
Maria K
MK
Mor
Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, University Drive (151C), Pittsburgh, PA 15240; Center for Research on Health Care, University of Pittsburgh School of Medicine, Suite 600, 230 McKee Place, Pittsburgh, PA 15213. Electronic address: borrerosp@upmc.edu.
Sonya
S
Borrero
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D003267:Contraception / Q000379:methods*; D003268:Contraception Behavior / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000208:ethnology; D044469:Racial Groups / Q000706:statistics & numerical data*; D013246:Sterilization, Tubal; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*; D058014:Veterans Health; D016387:Women's Health; D055815:Young Adult
Contraception; Family planning; Race; Unintended pregnancy; VA