PROVISION OF PATIENT-CENTERED CONTRACEPTIVE CARE FOR BALTIMORE LATINA/É PATIENTS

Objectives

We aimed to assess the association between patient characteristics and receipt of patient-centered contraceptive care among a sample of Latina/é patients in Baltimore, MD.

Methods

We assessed receipt of patient-centered contraceptive care among Latina/é patients aged 15-45 by audio-recording visits with six clinicians across four facilities. Patient-centeredness was assessed via analysis of the audio recordings using the Four Habits Coding Scheme (4HCS). Patients completed surveys using the Patient Centered Contraceptive Counseling (PCCC) measure. Multivariable logistic regression models tested the association between patient characteristics and PCCC and 4HCS scores. Qualitative interviews with a patient subset further characterized their experiences.

Results

A total of 52 visits and 29 interviews were analyzed. Some 64% of patients reported the highest possible ratings of patient-centered contraceptive counseling (PCCC). Researcher-reported 4HCS scores were notably less reflective of true patient-centered care provision. In adjusted models, neither PCCC nor 4HCS scores were significantly associated with patient characteristics. The discrepancy between PCCC and 4HCS scores is contextualized by interviews in which patients explain that compared to previous healthcare experiences, counseling received during the study period focused on their contraceptive preferences and involved interactions with kind, communicative clinicians/staff.

Conclusions

Positive ratings of experiences by Latina/é patients in the context of suboptimal patient-centered care on audio recordings suggests there may be a “low bar” of care, particularly for historically and currently marginalized groups. Provision of patient-centered contraceptive care requires attention to both patient-reported experiences and researcher-observed quality measures.