The role of contraceptive attributes in women's contraceptive decision making

Tessa Madden, Gina M. Secura, Robert F. Nease, Mary C. Politi, Jeffrey F. Peipert

Research output: Contribution to journalArticlepeer-review

75 Scopus citations

Abstract

Objective Contraceptive methods have differing attributes. Women's preferences for these attributes may influence contraceptive decision making. Our objective was to identify women's contraceptive preferences among women initiating a new contraceptive method. Study Design We conducted a cross-sectional, self-administered survey of women's contraceptive preferences at the time of enrollment into the Contraceptive CHOICE Project. Participants were asked to rank the importance of 15 contraceptive attributes on a 3-point scale (1 = not at all important, 2 = somewhat important, and 3 = very important) and then to rank the 3 attributes that were the most important when choosing a contraceptive method. The survey also contained questions about prior contraceptive experience and barriers to contraceptive use. Information about demographic and reproductive characteristics was collected through the CHOICE Project baseline survey. Results There were 2590 women who completed the survey. Our sample was racially and socioeconomically diverse. Method attributes with the highest importance score (mean score [SD]) were effectiveness (2.97 [0.18]), safety (2.96 [0.22]), affordability (2.61 [0.61]), whether the method is long lasting (2.58 [0.61]), and whether the method is "forgettable" (2.54 [0.66]). The attributes most likely to be ranked by respondents among the top 3 attributes included effectiveness (84.2%), safety (67.8%), and side effects of the method (44.6%). Conclusion Multiple contraceptive attributes influence decision making and no single attribute drives most women's decisions. Tailoring communication and helping women make complex tradeoffs between attributes can better support their contraceptive decisions and may assist them in making value-consistent choices. This process could improve continuation and satisfaction.

Original languageEnglish
Article number10252
Pages (from-to)46.e1-46.e6
JournalAmerican journal of obstetrics and gynecology
Volume213
Issue number1
DOIs
StatePublished - Jul 1 2015

Keywords

  • contraceptive attributes
  • contraceptive decision making
  • contraceptive implant
  • intrauterine device
  • preference-sensitive decision

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