Abstract
<h3>Objectives</h3> To explore clinicians' perspectives, challenges, needs, and ideas regarding contraceptive shared decision making and the design of patient decision support tools. <h3>Methods</h3> We conducted 45-minute semi-structured interviews with 15 family planning–focused clinicians in the US recruited from the Society of Family Planning listserv. We used an inductive content analysis approach to reveal themes within the transcripts. All transcripts were coded with an evolving codebook, and the first five transcripts were recoded with the finalized codebook. <h3>Results</h3> Twelve medical doctors and three nurse practitioners with an average of 19 years of experience participated. Thematic analysis indicated that clinicians support the ideology and practice of shared decision making in contraceptive counseling but may have trouble implementing it effectively due to time constraints, clinician cultural biases, or low reproductive health literacy among some patient groups. Suggested improvements to contraceptive counseling included incorporating clinical team members with health education, and increasing access to team members for continuous health education needs. Clinicians noted that some effective tools exist, but systems-level issues (eg, healthcare coverage and telemedicine access) play into the complexity of providing equitable decision support. <h3>Conclusions</h3> Based on these qualitative findings, shared decision-making tools used in contraceptive counseling should be designed to alleviate time constraints, mitigate cultural biases, and create a foundation of reproductive health knowledge. While effective tools exist, policies and system-level support are needed to ensure implementation addresses known gaps and that all patients have access to high-quality contraceptive counseling and shared decision making.
Published Version
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