Patient-provider communication before and after implementation of the contraceptive decision support tool My Birth Control.

Objective: To compare differences in patient-provider communication among patients who, prior to contraceptive counseling, used or did not use a decision support tool ("My Birth Control") which has educational and interactive modules and produces a provider printout with the patient's preferences.

Methods: As part of a cluster-randomized trial of the tool in four San Francisco safety net clinics, we collected and thematically analyzed 70 audio recordings of counseling visits (31 pre- and 39 post-tool implementation) from 15 providers randomized to the intervention.

Results: Without the tool, most providers began by asking participants what method they were considering and focused counseling on that method or on directing patients towards long-acting reversible contraception; with the tool, most focused on reviewing and discussing multiple methods of interest to the participant as indicated on the printout.

A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making.

Objectives: Barriers to the provision of patient-centered contraceptive counseling include time limitations, frequent misconceptions and misinformation about methods among patients, and the availability of numerous contraceptive options, which increases the complexity of contraceptive decision making. Decision support tools are interventions designed to facilitate quality decision making in preference-sensitive decisions. We evaluated the impact of a contraceptive decision support tool, My Birth Control, on providers' experience with contraceptive counseling.

Cluster randomized trial of a patient-centered contraceptive decision support tool, My Birth Control.

Background: Research suggests the need for improvement in the patient-centeredness and comprehensiveness of contraceptive counseling. My Birth Control is a tablet-based decision support tool designed to improve women's experience of contraceptive counseling and to help them select contraceptive methods that are consistent with their values and preferences.

Objective: The objective of this study was to evaluate the effect of My Birth Control on contraceptive continuation, experience of contraceptive care, and decision quality.

Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling.

Objective: We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection.

Methods: Drawing upon formative work around women's preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted.