Contraceptive counseling by general internal medicine faculty and residents

J Womens Health (Larchmt). 2014 Aug;23(8):707-13. doi: 10.1089/jwh.2013.4567. Epub 2014 Apr 25.

Abstract

Background: Almost half of US pregnancies are unintended, resulting in many abortions and unwanted or mistimed births. Contraceptive counseling is an effective tool to increase patients' use of contraception.

Methods: Using an online 20-item questionnaire, we evaluated the frequency of contraceptive counseling provided to reproductive-age women during a prevention-focused visit by University of Colorado internal medicine resident and faculty providers. We also evaluated factors hypothesized to affect contraceptive counseling frequency.

Results: Although more than 95% of the 146 medicine faculty and resident respondents agreed that contraceptive counseling is important, only one-quarter of providers reported providing contraceptive counseling "routinely" (defined as ≥80% of the time) to reproductive-age women during a prevention-focused visit. Providing contraceptive counseling routinely was strongly associated with taking an abbreviated sexual history "often"/"routinely" (odds ratio [OR]=11.6 [3.3 to 40.0]) and with high self-efficacy to provide contraceptive counseling (OR=6.5 [1.5 to 29.0]). However, fewer than two-thirds of providers reported taking an abbreviated sexual history "often"/"routinely." More than 70% of providers reported inadequate knowledge of contraceptive methods as a contraceptive counseling barrier. However, providers' perceived inadequate knowledge was not associated with traditional educational exposures, such as lectures and women's health electives.

Conclusions: In prevention-focused visits with reproductive-age women, a minority of internal medicine faculty and residents reported routine contraceptive counseling. Future efforts to increase contraceptive counseling among internists should include interventions that increase provider contraceptive counseling self-efficacy and ensure that providers obtain an abbreviated sexual history.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attitude of Health Personnel*
  • Colorado
  • Contraception*
  • Counseling*
  • Faculty
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Internal Medicine
  • Internship and Residency
  • Male
  • Patient Education as Topic
  • Physicians
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Surveys and Questionnaires
  • Women's Health