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Randomized Controlled Trial
. 2010 Oct;203(4):319.e1-8.
doi: 10.1016/j.ajog.2010.05.009. Epub 2010 Jul 2.

Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status

Christine Dehlendorf  1 , Rachel Ruskin, Kevin Grumbach, Eric Vittinghoff, Kirsten Bibbins-Domingo, Dean Schillinger, Jody Steinauer
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Randomized Controlled Trial

Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status

Christine Dehlendorf et al. Am J Obstet Gynecol. .
Free PMC article
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Abstract

Objective: Recommendations by health care providers have been found to vary by patient race/ethnicity and socioeconomic status and may contribute to health disparities. This study investigated the effect of these factors on recommendations for contraception.

Study design: One of 18 videos depicting patients of varying sociodemographic characteristics was shown to each of 524 health care providers. Providers indicated whether they would recommend levonorgestrel intrauterine contraception to the patient shown in the video.

Results: Low socioeconomic status whites were less likely to have intrauterine contraception recommended than high socioeconomic status whites (odds ratio [OR], 0.20; 95% confidence interval [CI], 0.06-0.69); whereas, socioeconomic status had no significant effect among Latinas and blacks. By race/ethnicity, low socioeconomic status Latinas and blacks were more likely to have intrauterine contraception recommended than low socioeconomic status whites (OR, 3.4; and 95% CI, 1.1-10.2 and OR, 3.1; 95% CI, 1.0-9.6, respectively), with no effect of race/ethnicity for high socioeconomic status patients.

Conclusion: Providers may have biases about intrauterine contraception or make assumptions about its use based on patient race/ethnicity and socioeconomic status.

Figures

Figure 1
Figure 1
Figure 1a: Low SES White Patient Figure 1b: High SES White Patient Figure 1c: Low SES Black Patient Figure 1d: High SES Black Patient Figure 1e: Low SES Latina Patient Figure 1f: High SES Latina Patient
Figure 1
Figure 1
Figure 1a: Low SES White Patient Figure 1b: High SES White Patient Figure 1c: Low SES Black Patient Figure 1d: High SES Black Patient Figure 1e: Low SES Latina Patient Figure 1f: High SES Latina Patient
Figure 1
Figure 1
Figure 1a: Low SES White Patient Figure 1b: High SES White Patient Figure 1c: Low SES Black Patient Figure 1d: High SES Black Patient Figure 1e: Low SES Latina Patient Figure 1f: High SES Latina Patient
Figure 1
Figure 1
Figure 1a: Low SES White Patient Figure 1b: High SES White Patient Figure 1c: Low SES Black Patient Figure 1d: High SES Black Patient Figure 1e: Low SES Latina Patient Figure 1f: High SES Latina Patient
Figure 1
Figure 1
Figure 1a: Low SES White Patient Figure 1b: High SES White Patient Figure 1c: Low SES Black Patient Figure 1d: High SES Black Patient Figure 1e: Low SES Latina Patient Figure 1f: High SES Latina Patient
Figure 1
Figure 1
Figure 1a: Low SES White Patient Figure 1b: High SES White Patient Figure 1c: Low SES Black Patient Figure 1d: High SES Black Patient Figure 1e: Low SES Latina Patient Figure 1f: High SES Latina Patient
Figure 2
Percent of Providers Recommending IUC to Women with No Perceived Risk Factors, Stratified by Patient SES and Race/Ethnicity (n=173)
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