The Program in Woman-Centered Contraception

Statement of Purpose

The Program in Woman-Centered Contraception (PWCC) is dedicated to the idea that women should be at the heart of all family planning efforts. Through listening to what women want in contraception and contraceptive care, we can best meet their reproductive needs and ensure their reproductive autonomy. To accomplish this goal, we engage in activities designed to develop, evaluate and disseminate innovative family planning interventions, as well as conduct formative research to deepen our understanding of women’s preferences and experiences around contraception. Our work focuses on low-income and diverse populations and includes research investigating provider-patient interactions in the family planning setting, women’s social communication around birth control methods, contraceptive decision-making, and family planning disparities.

Staff

Christine Dehlendorf, MD, MAS
Director
Associate Professor, Department of Family and Community Medicine
 
Kirsten Thompson, MPH
Project Director, Bixby Center for Global Reproductive Health
 
Edith Fox, MPH
Research Program Manager
 
Maria Paula Campora Perez, MD
Assistant Clinical Research Coordinator
 
Marina Galvez
Assistant Clinical Research Coordinator
 
Ilana Silverstein
Assistant Clinical Research Coordinator
 
Reiley Reed, MPH
Research Project Manager
 
Whitney Wilson, MPH
Research Project Manager

Collaborators

Bedsider.org

Professor
Department of General Internal Medicine
University of California, Davis
 
Associate Professor
Division of General and Internal Medicine
Department of Medicine
University of Pittsburgh
 
Professor
Department of Global Health
School of Public Health
University of Washington
 
Assistant Professor
Department of Obstetrics, Gynecology & Reproductive Sciences
University of California, San Francisco
 
Associate Professor
Advancing New Standards in Reproductive Health (ANSIRH)
Bixby Center for Global Reproductive Health
Department of Obstetrics, Gynecology & Reproductive Sciences
University of California, San Francisco
 
Professor
Center for Reproductive Sciences
Department of Obstetrics, Gynecology & Reproductive Sciences
 
Counseling and Administrative Manager
Women’s Options Center
San Francisco General Hospital
 
Department of Obstetrics, Gynecology & Reproductive Sciences
University of California, San Francisco
 
Professor
Department of Preventive Medicine
Institute for Prevention Research
Keck School of Medicine
University of Southern California
 
Professor
Department of Epidemiology and Biostatistics
University of California, San Francisco

Current Projects

Image of doctor and patient examining IUD

Photo credit Cindy Chew

Putting the focus on women’s contraceptive counseling experiences

Patient-centeredness in contraceptive counseling is essential to quality family planning care. In 2016, PWCC began work on a three-year project to refine and test a Patient-Reported Outcome Measure (PROM) and Patient-Reported Outcome Performance Measure (PRO-PM) to understand patients’ experiences of contraceptive counseling and inform improvements to counseling practices. The PROM and PRO-PM will be based on the Interpersonal Quality of Family Planning Care (IQFP) scale previously developed by Dr. Dehlendorf.

Clip art image of mother holding baby

Identifying Strategies to Improve the Family Planning Experiences of Peripartum Women

The UCSF Preterm Birth Initiative California (PTBi-CA) focuses on discovering and enacting innovative approaches to improve birth outcomes for women and infants in San Francisco, Oakland, and Fresno. PWCC began work with PTBi-CA in 2016 to explore how family planning care might play a role in narrowing San Francisco’s preterm birth disparities. PWCC will engage community stakeholders and conduct formative work around women of color’s attitudes and preferences for perinatal family planning care and contraceptive counseling. Results will potentially inform the development of an intervention to improve the family planning experiences of peripartum women at risk for preterm birth.

My Birth Control pamphlet cover

My Birth Control: Development of a Decision Support Tool for Contraception

Funded by the Patient-Centered Outcomes Research Institute (PCORI), this project involves the development of a tablet-based contraceptive decision support tool for women and a large-scale, longitudinal randomized control trial to test its effectiveness in four clinics in San Francisco. The My Birth Control tool was designed by PWCC in collaboration with designers from Bedsider.org. The trial will inform PWCC’s plan to disseminate the tool for wider use in diverse family planning care settings.

Clip art image of "Speakout" speech bubbles

SpeakOut: Harnessing the Power of Social Networks to Disseminate Contraceptive Information among Adolescents

In 2015, PWCC received a 5-year grant from the Office of Adolescent Health to develop, rigorously evaluate, and disseminate SpeakOut, a social communication intervention about intrauterine devices (IUDs) and subdermal contraceptive implants for adolescents age 15 to 19. As friends and family members are valuable sources of contraceptive information for young people, SpeakOut encourages IUD and implant users to share their experiences so that their peers can be informed and empowered to make their own decisions about these methods. SpeakOut includes a clinic session, pamphlets, website, and text messages and is based on the intervention WhyIUD, previous piloted by PWCC.

Image of IUDs

Birth Control Connect: Online Peer Influence on IUD Behaviors and Attitudes

A collaboration between PWCC and researchers at the University of Pennsylvania Annenberg School of Communication, this study will investigate a possible association between women’s social exposure to intrauterine device (IUD) users in an online social network, and change in attitudes and behaviors related to IUD use. The study is funded by the Hewlett Foundation.

Image of clinician and patient

Contraceptive Counseling and Women’s Contraceptive Experiences

PWCC is currently analyzing data from a cohort study investigating contraceptive counseling, which involved audiorecording over 300 contraceptive counseling visits and followed women for six months after their visit to explore women’s experiences of contraceptive counseling and to determine what aspects of counseling are associated with satisfaction with family planning care and with contraceptive continuation.

Selected Presentations

“Shared Decision Making in Contraceptive Counseling” – Webinar presented by Dr. Dehlendorf for the California Prevention Training Center, 2016.

“Learning from someone who knows: Teens’ preferences for social communication about contraception” – Poster at the 2016 HHS Teen Pregnancy Prevention Grantee Conference, July 2016.

“MyBirthControl: Engaging patient and providers in shared decision making around contraception” – Presentation at YTH (Youth Technology Health), May 2016.

“From WhyIUD to SpeakOut: Adapting a Peer-to-Peer Contraceptive Education Intervention for Adolescents” – Presentation at YTH (Youth Technology Health), May 2016.

“Preventable, unnecessary and unjust? Rethinking family planning disparities using the health equity framework” – Presentation at the 2015 North American Forum on Family Planning, featuring Christine Dehlendorf, MD, MAS; Melissa Gilliam, MD, MPH (Moderator); Anu Gomez, PhD; Andrea Jackson, MD, MAS.

“Prioritizing preferences in reproductive health care: the role of shared decision making” – Presentation at the 2015 North American Forum on Family Planning featuring Christine Dehlendorf, MD, MAS; Liza Fuentes, MPH; Jennifer Kerns, MD, MPH; Bhavik Kumar, MD; and Robin Wallace, MD.

“Abortion Disparities: A Public Health Approach” and “Abortion in the Primary Care Setting” – Lectures presented by Dr. Dehlendorf as part of the Innovating Education in Reproductive Health course, Abortion: Quality Care and Public Health Implications

“Contraceptive Counseling and LARC Uptake” – Webinar presented by Dr. Dehlendorf, hosted by the American College of Obstetricians and Gynecologists’ LARC Program

“Differences in contraceptive use between family planning providers and the U.S.” – Session at the 2014 North American Forum on Family Planning featuring Dr. Dehlendorf; Lawrence Finer, PhD; Liza Fuentes, MPH; and Lisa Stern, MSN, APRN

2014 North American Forum on Family Planning poster presentations:


Publications

 

Dehlendorf C, Grumbach K, Schmittdiel JA, Steinauer J. Shared Decision Making in Contraceptive Counseling. Contraception. 2017 Jan 06. PMID: 28069491.

Kimport K, DehlendorkC, Borrero S. Patient-provider conversations about sterilization: a qualitative analysis. Contraception. 2016 Nov4. PMID: 27823943.

Aiken AR, Borrero S, Callegari LS, Dehlendorf C. Rethinking the Pregnancy Planning Paradigm: Unintended Conceptions or Unrepresentative Concepts? Perspect Sex Reprod Health. 2016 Sep; 48(3):147-51. PMID: 27513444.

Dehlendorf C, Henderson JT, Vittinghoff E, Grumbach K, Levy K, Schmittdiel J, Lee J, Schillinger D, Steinauer J. Association of the quality of interpersonal care during family planning counseling with contraceptive use. American Journal of Obstetrics and Gynecology 2016; 215(1) 78.e1–78.e9.

Dehlendorf C, Fox E, Sobel L, Borrero S. Patient-centered contraceptive counseling: Evidence to inform practice. Current Obstetrics and Gynecology Reports 2016; 5(1) 55-63.

Gubrium AC, Mann ES, Borrero S, Dehlendorf C, Fields J, Geronimus AT, Gómez AM, Harris LH, Higgins JA, Kimport K, Luker K. Realizing reproductive health equity needs more than long-acting reversible contraception (LARC). American Journal of Public Health 2016; 106(1).

Jackson AV, Karasek D, Dehlendorf C, Foster DG. Racial and ethnic differences in women's preferences for features of contraceptive methods. Contraception 2016; 93(5) 406-11.

Dehlendorf CE, Fox EE, Ali RF, Anderson NC, Reed RD, Lichtenberg ES. Medication abortion failure in women with and without previous cesarean delivery. Contraception. 2015 Nov; 92(5):463-8.

Grady CD, Dehlendorf C, Cohen ED, Schwarz EB, Borrero S. Racial and ethnic differences in contraceptive use among women who desire no future children, 2006-2010 National Survey of Family Growth. Contraception. 2015 Jul; 92(1):62-70.

Dehlendorf C, Bellanca H, Policar M. Performance measures for contraceptive care: what are we actually trying to measure? Contraception. 2015 Jun; 91(6):433-7.

Levy K, Minnis AM, Lahiff M, Schmittdiel J, Dehlendorf C. Bringing patients' social context into the examination room: an investigation of the discussion of social influence during contraceptive counseling. Womens Health Issues. 2015 Jan-Feb; 25(1):13-21.

Minnis AM, Mavedzenge SN, Luecke E, Dehlendorf C. Provider counseling to young women seeking family planning services. Perspect Sex Reprod Health. 2014 Dec; 46(4):223-31.

Dehlendorf C, Kimport K, Levy K, Steinauer J. A qualitative analysis of approaches to contraceptive counseling. Perspect Sex Reprod Health. 2014 Dec; 46(4):233-40.

Dehlendorf C, Krajewski C, Borrero S. Contraceptive counseling: best practices to ensure quality communication and enable effective contraceptive use. Clin Obstet Gynecol. 2014 Dec; 57(4):659-73.

Anderson N, Steinauer J, Valente T, Koblentz J, Dehlendorf C. Women's Social Communication About IUDs: A Qualitative Analysis. Perspect Sex Reprod Health. 2014 Sep; 46(3):141-8.

Elwyn G, Dehlendorf C, Epstein RM, Marrin K, White J, Frosch DL. Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems. Ann Fam Med. 2014 May-Jun; 12(3):270-5.

Craig AD, Dehlendorf C, Borrero S, Harper CC, Rocca CH. Exploring young adults' contraceptive knowledge and attitudes: disparities by race/ethnicity and age. Womens Health Issues. 2014 May-Jun; 24(3):e281-9.

Dehlendorf C, Tharayil M, Anderson N, Gbenedio K, Wittman A, Steinauer J. Counseling About IUDs: A Mixed-Methods Analysis. Perspect Sex Reprod Health. 2014 Sep; 46(3):133-40.

Dehlendorf C, Park SY, Emeremni CA, Comer D, Vincett K, Borrero S. Racial/ethnic disparities in contraceptive use: variation by age and women's reproductive experiences. Am J Obstet Gynecol. 2014 Jun; 210(6):526.e1-9.

Kennedy S, Grewal M, Roberts EM, Steinauer J, Dehlendorf C. A Qualitative Study of Pregnancy Intention and the Use of Contraception among Homeless Women with Children. J Health Care Poor Underserved. 2014; 25(2):757-70.

Dehlendorf C, Harris LH, Weitz TA. Disparities in abortion rates: a public health approach. Am J Public Health. 2013 Oct; 103(10):1772-9.

Borrero S, Farkas A, Dehlendorf C, Rocca CH. Racial and ethnic differences in men's knowledge and attitudes about contraception. Contraception. 2013 Oct; 88(4):532-8.

Dobkin LM, Perrucci AC, Dehlendorf C. Pregnancy options counseling for adolescents: overcoming barriers to care and preserving preference. Curr Probl Pediatr Adolesc Health Care. 2013 Apr; 43(4):96-102.

Steinauer JE, Sokoloff A, Roberts EM, Drey EA, Dehlendorf CE, Prager SW. Immediate versus delayed initiation of the contraceptive patch after abortion: a randomized trial. Contraception. 2014 Jan; 89(1):42-7.

Wallace R, Dehlendorf C, Vittinghoff E, Gold KJ, Dalton VK. Early pregnancy failure management among family physicians. Fam Med. 2013 Mar; 45(3):173-9.

Goodman S, Shih G, Hawkins M, Feierabend S, Lossy P, Waxman NJ, Gold M, Dehlendorf C. A long-term evaluation of a required reproductive health training rotation with opt-out provisions for family medicine residents. Fam Med. 2013 Mar; 45(3):180-6.

Diedrich JT, Drey EA, Dehlendorf C, Steinauer JE. Women's questions after postabortion insertion of intrauterine contraception. Contraception. 2013 Sep; 88(3):396-400.

Dehlendorf C, Levy K, Kelley A, Grumbach K, Steinauer J. Women's preferences for contraceptive counseling and decision making. Contraception. 2013 Aug; 88(2):250-6.

Shih G, Dubé K, Dehlendorf C. "We never thought of a vasectomy": a qualitative study of men and women's counseling around sterilization. Contraception. 2013 Sep; 88(3):376-81.

Shih G, Dubé K, Sheinbein M, Borrero S, Dehlendorf C. He's a real man: a qualitative study of the social context of couples' vasectomy decisions among a racially diverse population. Am J Mens Health. 2013 May; 7(3):206-13.

Harper CC, Henderson JT, Raine TR, Goodman S, Darney PD, Thompson KM, Dehlendorf C, Speidel JJ. Evidence-based IUD practice: family physicians and obstetrician-gynecologists. Fam Med. 2012 Oct; 44(9):637-45.

Brown MK, Auerswald C, Eyre SL, Deardorff J, Dehlendorf C. Identifying counseling needs of nulliparous adolescent intrauterine contraceptive users: a qualitative approach. J Adolesc Health. 2013 Mar; 52(3):293-300.

Steinauer J, Dehlendorf C, Grumbach K, Landy U, Darney P. Multi-specialty family planning training: collaborating to meet the needs of women. Contraception. 2012 Sep; 86(3):188-90.

Dehlendorf C, Grumbach K, Vittinghoff E, Ruskin R, Steinauer J. A study of physician recommendations for reversible contraceptive methods using standardized patients. Perspect Sex Reprod Health. 2011 Dec; 43(4):224-9.

Dehlendorf C, Foster DG, de Bocanegra HT, Brindis C, Bradsberry M, Darney P. Race, ethnicity and differences in contraception among low-income women: methods received by Family PACT Clients, California, 2001-2007. Perspect Sex Reprod Health. 2011 Sep; 43(3):181-7.

Shih G, Vittinghoff E, Steinauer J, Dehlendorf C. Racial and ethnic disparities in contraceptive method choice in California. Perspect Sex Reprod Health. 2011 Sep; 43(3):173-80.

Dehlendorf C, Weitz T. Access to abortion services: a neglected health disparity. J Health Care Poor Underserved. 2011 May; 22(2):415-21.

Dehlendorf C, Rinehart W. Communication in reproductive health: intimate topics and challenging conversations. Patient Educ Couns. 2010 Dec; 81(3):321-3.

Dehlendorf C, Diedrich J, Drey E, Postone A, Steinauer J. Preferences for decision-making about contraception and general health care among reproductive age women at an abortion clinic. Patient Educ Couns. 2010 Dec; 81(3):343-8.

Dehlendorf C, Ruskin R, Grumbach K, Vittinghoff E, Bibbins-Domingo K, Schillinger D, Steinauer J. Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status. Am J Obstet Gynecol. 2010 Oct; 203(4):319.e1-8.

Borrero S, Abebe K, Dehlendorf C, Schwarz EB, Creinin MD, Nikolajski C, Ibrahim S. Racial variation in tubal sterilization rates: role of patient-level factors. Fertil Steril. 2011 Jan; 95(1):17-22.

Dehlendorf C, Ruskin R, Darney P, Vittinghoff E, Grumbach K, Steinauer J. The effect of patient gynecologic history on clinician contraceptive counseling. Contraception. 2010 Sep; 82(3):281-5.

Dehlendorf C, Rodriguez MI, Levy K, Borrero S, Steinauer J. Disparities in family planning. Am J Obstet Gynecol. 2010 Mar; 202(3):214-20.

Dehlendorf C, Bryant AS, Huddleston HG, Jacoby VL, Fujimoto VY. Health disparities: definitions and measurements. Am J Obstet Gynecol. 2010 Mar; 202(3):212-3.

Dehlendorf C, Levy K, Ruskin R, Steinauer J. Health care providers' knowledge about contraceptive evidence: a barrier to quality family planning care? Contraception. 2010 Apr; 81(4):292-8.

Dehlendorf C, Marchi K, Vittinghoff E, Braveman P. Sociocultural determinants of teenage childbearing among Latinas in California. Matern Child Health J. 2010 Mar; 14(2):194-201.

Dehlendorf CE, Grumbach K. Medical liability insurance as a barrier to the provision of abortion services in family medicine. Am J Public Health. 2008 Oct; 98(10):1770-4.

Brahmi D, Dehlendorf C, Engel D, Grumbach K, Joffe C, Gold M. A descriptive analysis of abortion training in family medicine residency programs. Fam Med. 2007 Jun; 39(6):399-403.

Dehlendorf C, Brahmi D, Engel D, Grumbach K, Joffe C, Gold M. Integrating abortion training into family medicine residency programs. Fam Med. 2007 May; 39(5):337-42.


In the Press

Apple Maps Had Been Directing People Searching For Abortion Clinics to Adoption Centers since 2011 TechCrunch, January 29, 2016.

Apple Maps Stops Sending People Searching for Abortion’ to Adoption Centers. Fast Company, January 28, 2016.

Long-Acting Contraception Makes Teen Pregnancy Rates Plummet. So Why Are Some Women Still Skeptical? The Nation, October 28, 2015.