Martina T Caldwell1, Nanci Hambrick2, Phyllis Vallee3, Celia S D Thomas4, April Sutton5, Gwendolyn Daniels6, Nikhil Goyal7, Jacob Manteuffel3, Christine L M Joseph8, Timothy C Guetterman9. 1. Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI. Electronic address: mcaldwe2@hfhs.org. 2. Center for Behavioral Health and Justice, Wayne State University School of Social Work, Detroit, MI. 3. Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI. 4. Alternatives for Girls, Detroit, MI. 5. Black Family Development, Inc., Detroit, MI. 6. Institute for Population Health, Detroit, MI. 7. Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI; Department of Internal Medicine, Henry Ford Hospital, Detroit, MI. 8. Department of Public Health Sciences, Henry Ford Health System, Detroit, MI. 9. Department of Family Medicine, University of Michigan, Ann Arbor, MI.
Abstract
STUDY OBJECTIVE: We explore reproductive-aged women's acceptance of contraception counseling in the emergency department (ED). METHODS: This study is phase 1 of an exploratory sequential mixed methods study. We purposively interviewed 31 participants with the following criteria: black, white, or Latina race/ethnicity; nonpregnant; aged 15 to 44 years; receiving nonemergency care; not using highly effective contraception; and did not intend to become pregnant. We conducted semistructured interviews with a piloted interview guide until reaching thematic saturation. We coded transcripts with an iteratively developed codebook, maintaining intercoder agreement greater than 80%. Qualitative acceptance of ED contraception counseling was grouped into 3 categories: acceptable, unacceptable, and equivocal. We conducted a thematic text analysis to assess themes expressing support and concern for ED contraception counseling. Qualitative findings were stratified by age, race, and frequency of ED use. Using components of grounded theory, we developed a conceptual model. RESULTS: Most participants (81%) accepted ED contraception counseling. Themes expressing support and concern for ED contraception counseling included opportunity to address women's unmet contraception needs, contraception is within the scope of ED practice, the ED is a convenient setting with competent providers, contraception is a sensitive topic, and the ED may be an inappropriate setting for some women. Latina participants had lower acceptance of ED contraception counseling. Dominant subthemes varied slightly by race, age, and frequency of ED use. CONCLUSION: Diverse women had high acceptance of contraception counseling in the ED. Perspectives expressing both support and concern in regard to ED contraception counseling were explored in detail.
STUDY OBJECTIVE: We explore reproductive-aged women's acceptance of contraception counseling in the emergency department (ED). METHODS: This study is phase 1 of an exploratory sequential mixed methods study. We purposively interviewed 31 participants with the following criteria: black, white, or Latina race/ethnicity; nonpregnant; aged 15 to 44 years; receiving nonemergency care; not using highly effective contraception; and did not intend to become pregnant. We conducted semistructured interviews with a piloted interview guide until reaching thematic saturation. We coded transcripts with an iteratively developed codebook, maintaining intercoder agreement greater than 80%. Qualitative acceptance of ED contraception counseling was grouped into 3 categories: acceptable, unacceptable, and equivocal. We conducted a thematic text analysis to assess themes expressing support and concern for ED contraception counseling. Qualitative findings were stratified by age, race, and frequency of ED use. Using components of grounded theory, we developed a conceptual model. RESULTS: Most participants (81%) accepted ED contraception counseling. Themes expressing support and concern for ED contraception counseling included opportunity to address women's unmet contraception needs, contraception is within the scope of ED practice, the ED is a convenient setting with competent providers, contraception is a sensitive topic, and the ED may be an inappropriate setting for some women. Latina participants had lower acceptance of ED contraception counseling. Dominant subthemes varied slightly by race, age, and frequency of ED use. CONCLUSION: Diverse women had high acceptance of contraception counseling in the ED. Perspectives expressing both support and concern in regard to ED contraception counseling were explored in detail.