The Influence of Trust in the Health Care System on Postpartum Contraceptive Choice

Study Overview
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Brief Summary
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The purpose of this research is to understand the relationship between trust in the health care system and choice of contraception during the postpartum period among pregnant women receiving prenatal care. Research subjects will complete a questionnaire at enrollment and between delivery and within 5 days of hospital discharge. A chart review will also be completed to gather use of a birth control method at the six week postpartum visit as well as pertinent medical diagnoses and recorded data such as height, weight, body mass index, and contraceptive plan as documented in the postpartum medical chart.

Detailed Description
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The aims of the proposed research are three-fold: To identify whether trust in the health care system is associated with choice of the highest efficacy contraception (intrauterine contraception, implantable contraception, and sterilization) in the immediate postpartum period among pregnant women receiving prenatal care. To explore which patient-level factors (sociodemographic, reproductive history, future pregnancy intentions) and provider-level factors (antenatal contraceptive counseling) are associated with choice of the highest efficacy contraception in the immediate postpartum period among pregnant women receiving prenatal care. To determine whether trust in the health care system is altered during the receipt of prenatal care or delivery.

Official Title
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The Influence of Trust in the Health Care System on Postpartum Contraceptive Choice

Conditions
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Contraception, Contraception Behavior

Intervention / Treatment
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* Other: Questionnaire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant Women receiving prenatal care at Medical University of South Carolina (MUSC) Age 18 or older Exclusion Criteria: Greater than 20 weeks gestation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Questionnaire<br>A questionnaire will be administered during the early stages of prenatal care & again during the postpartum period. The initial questionnaire will assess trust in the health care system, locus of control, religiosity, health literacy & collect information about demographics, contraceptive & reproductive history, future pregnancy intentions, & baseline knowledge about contraception. The postpartum questionnaire will repeat questions about future pregnancy & contraception intentions, trust in the health care system, knowledge of contraception and collect new information about characteristics of antenatal contraceptive counseling received including whether a provider recommended a specific method of contraception, the amount of counseling received, & the type of counseling received. | Other: Questionnaire<br>* A questionnaire will be administered during the early stages of prenatal care & again during the postpartum period. The initial questionnaire will assess trust in the health care system, locus of control, religiosity, health literacy & collect information about demographics, contraceptive & reproductive history, future pregnancy intentions, & baseline knowledge about contraception. The postpartum questionnaire will repeat questions about future pregnancy & contraception intentions, trust in the health care system, knowledge of contraception and collect new information about characteristics of antenatal contraceptive counseling received including whether a provider recommended a specific method of contraception, the amount of counseling received, & the type of counseling received.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Choice of long acting contraception (IUD or implant) for postpartum contraception | Using a questionnaire adminstered immediately postpartum, we will ascertain whether participants indicate plan to use either an IUD or implant for contraception. We will also measure use of IUD or implant through chart abstraction of their 6 week postpartum visit. | immediately postpartum | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Trust in the health care system | We will also evaluate trust as an outcome and evaluate whether certain patient-level or antepartum care characteristics predict higher levels of trust. Trust is measured through a validated scale containing 17 questions measured using a likert scale. | immediately postpartum | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pregnant Women, Women's Health, Contraception, Trust in Health Care