Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status
Open accessAbstract
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.
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Dehlendorf 2010 found no effect of race/ethnicity for high SES patients.
“By race/ethnicity, low SES Latinas and blacks were more likely to have intrauterine contraception recommended than low SES whites, with no effect of race/ethnicity for high SES patients.”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [39]
Dehlendorf 2010 found by race/ethnicity, low SES Latinas and blacks were more likely to have intrauterine contraception recommended than low SES whites.
“By race/ethnicity, low SES Latinas and blacks were more likely to have intrauterine contraception recommended than low SES whites, with no effect of race/ethnicity for high SES patients.”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [39]
Dehlendorf 2010 found low SES whites were less likely to have intrauterine contraception recommended than high SES whites.
“Low SES whites were less likely to have intrauterine contraception recommended than high SES whites.”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [39]
Dehlendorf 2010 found low SES patients were judged to be significantly more likely than high SES patients to have an STI and an unintended pregnancy.
“Low SES patients were judged to be significantly more likely than high SES patients to have an STI and an unintended pregnancy, and were also judged to be less knowledgeable.”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [39]
Dehlendorf 2010 found low SES patients were judged to be less knowledgeable.
“Low SES patients were judged to be significantly more likely than high SES patients to have an STI and an unintended pregnancy, and were also judged to be less knowledgeable.”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [39]
In another study, low SES Latinas and blacks were more likely to have intrauterine contraception recommended than low SES whites, but there was no effect of race for high SES patients.
“In another, low SES Latinas and blacks were more likely to have intrauterine contraception recommended than low SES whites, but there was no effect of race for high SES patients [39].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [39]
One study found evidence of bias against low SES Latina patients, but not against high SES Latinas.
“one study only found evidence of bias against low SES Latina patients, not against high SES Latinas”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [39]
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Cites
Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology
Burgess, D., van Ryn, M., Dovidio, J., & Saha, S. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0160-1 · Cited by 495 · see citing works
Flagged first, then by citations
Research works printed but not linked: 31
- [1]Smedley B Stith A Nelson A Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare 2003 Washington, D.C. The National Academies Press 25032386
- [2]van Ryn M Fu SS Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health? Am J Public Health 2003 93 2 248 255 12554578 PMC1447725
- [3]Sabin JA Rivara FP Greenwald AG Physician implicit attitudes and stereotypes about race and quality of medical care Med Care 2008 46 7 678 685 18580386
- [4]McKinlay J Link C Marceau L O'Donnell A Arber S Adams A How do doctors in different countries manage the same patient? Results of a factorial experiment Health Serv Res 2006 41 6 2182 2220 17116115 PMC1955316
- [5]Schulman KA Berlin JA Harless W Kerner JF Sistrunk S Gersh BJ The effect of race and sex on physicians' recommendations for cardiac catheterization N Engl J Med 1999 340 8 618 626 10029647
- [6]van Ryn M Burgess D Malat J Griffin J Physicians' perceptions of patients' social and behavioral characteristics and race disparities in treatment recommendations for men with coronary artery disease Am J Public Health 2006 96 2 351 357 16380577 PMC1470483
- [7]Bao Y Fox SA Escarce JJ Socioeconomic and racial/ethnic differences in the discussion of cancer screening: "between-" versus "within-" physician differences Health Serv Res 2007 4 3 Pt 1 950 970 17489898 PMC1955263
- [8]Griggs JJ Culakova E Sorbero ME Poniewierski MS Wolff DA Crawford J Social and racial differences in selection of breast cancer adjuvant chemotherapy regimens J Clin Oncol 2007 25 18 2522 2527 17577029
- [10]Krupat E Irish JT Kasten LE Freund KM Burns RB Moskowitz MA Patient assertiveness and physician decision-making among older breast cancer patients Soc Sci Med 1999 49 4 449 457 10414805
- [11]Borrero S Schwarz EB Creinin M Ibrahim S The impact of race and ethnicity on receipt of family planning services in the United States J Womens Health (Larchmt) 2009 18 1 91 96 19072728 PMC2743980
- [12]Downing RA LaVeist TA Bullock HE Intersections of ethnicity and social class in provider advice regarding reproductive health Am J Public Health 2007 97 10 1803 1807 17761569 PMC1994173
- [13]Harrison DD Cooke CW An elucidation of factors influencing physicians' willingness to perform elective female sterilization Obstet Gynecol 1988 72 4 565 570 3419736
- [14]Chandra A Martinez GM Mosher WD Abma JC Jones J Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth Vital Health Stat 23 2005 25 1 160 16532609
- [15]Finer LB Henshaw SK Disparities in rates of unintended pregnancy in the United States, 1994 and 2001 Perspect Sex Reprod Health 2006 38 2 90 96 16772190
- [17]Stanwood NL Garrett JM Konrad TR Obstetrician-gynecologists and the intrauterine device: a survey of attitudes and practice Obstet Gynecol 2002 99 2 275 280 11814509
- [18]Harper CC Blum M de Bocanegra HT Darney PD Speidel JJ Policar M Challenges in translating evidence to practice: the provision of intrauterine contraception Obstet Gynecol 2008 111 6 1359 1369 18515520
- [19]Hubacher D Lara-Ricalde R Taylor DJ Guerra-Infante F Guzman-Rodriguez R Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women N Engl J Med 2001 345 8 561 567 11529209
- [20]Farley TM Rosenberg MJ Rowe PJ Chen JH Meirik O Intrauterine devices and pelvic inflammatory disease: an international perspective Lancet 1992 339 8796 785 788 1347812
- [21]MacIsaac L Espey E Intrauterine contraception: the pendulum swings back Obstet Gynecol Clin North Am 2007 34 1 91 111 ix 17472867
- [22]Hubacher D Vilchez R Gmach R Jarquin C Medrano J Gadea A The impact of clinician education on IUD uptake, knowledge and attitudes: results of a randomized trial Contraception 2006 73 6 628 633 16730497
- [24]Farmer MM Ferraro KF Are racial disparities in health conditional on socioeconomic status? Soc Sci Med 2005 60 1 191 204 15482878
- [25]McKinlay JB Burns RB Durante R Feldman HA Freund KM Harrow BS Patient, physician and presentational influences on clinical decision making for breast cancer: results from a factorial experiment J Eval Clin Pract 1997 3 1 23 57 9238607
- [26]Woo JK Ghorayeb SH Lee CK Sangha H Richter S Effect of patient socioeconomic status on perceptions of first- and second-year medical students CMAJ 2004 170 13 1915 1919 15210639 PMC421718
- [27]McKinlay JB Link CL Freund KM Marceau LD O'Donnell AB Lutfey KL Sources of variation in physician adherence with clinical guidelines: results from a factorial experiment J Gen Intern Med 2007 22 3 289 296 17356957 PMC1824760
- [28]Balsa AI McGuire TG Meredith LS Testing for statistical discrimination in health care Health Serv Res 2005 40 1 227 252 15663711 PMC1361135
- [29]Krieger N Waterman PD Chen JT Soobader MJ Subramanian SV Monitoring socioeconomic inequalities in sexually transmitted infections, tuberculosis, and violence: geocoding and choice of area-based socioeconomic measures--the public health disparities geocoding project (US) Public Health Rep 2003 118 3 240 260 12766219 PMC1497538
- [30]Stern AM Sterilized in the name of public health: race, immigration, and reproductive control in modern California Am J Public Health 2005 95 7 1128 1138 15983269 PMC1449330
- [31]Critchlow DT Birth control, population control, and family planning: an overview J Policy Hist 1995 7 1 1 21 12346341
- [32]Thorburn S Bogart LM Conspiracy beliefs about birth control: barriers to pregnancy prevention among African Americans of reproductive age Health Educ Behav 2005 32 4 474 487 16009745
- [33]Becker D Tsui AO Reproductive health service preferences and perceptions of quality among low-income women: racial, ethnic and language group differences Perspect Sex Reprod Health 2008 40 4 202 211 19067933
- [34]Beach MC Rosner M Cooper LA Duggan PS Shatzer J Can patient-centered attitudes reduce racial and ethnic disparities in care? Acad Med 2007 82 2 193 198 17264700 PMC3137286
Cited by
Sorted by citations
Implicit bias in healthcare professionals: a systematic review
FitzGerald, C., & Hurst, S. (2017) · BMC Medical Ethics · doi:10.1186/s12910-017-0179-8 · Cited by 2,398 · see citing works
- Authors
- Dehlendorf, C., Ruskin, R., Grumbach, K., Vittinghoff, E., Bibbins-Domingo, K., Schillinger, D., & Steinauer, J.
- Affiliations
- University of California, San Francisco (US)
- ORCID
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 203
- Issue
- 4
- Pages
- 319.e1-319.e8
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC3012124
- OpenAlex
- W2118223767
- Cited by
- 249
- References
- 1
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 25 · 2023: 25 · 2022: 30 · 2021: 25 · 2020: 26 · 2019: 22 · 2018: 9 · 2017: 14 · 2016: 8 · 2015: 4 · 2014: 9 · 2013: 7 · 2012: 4
- FWCI
- 7.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Center for Research Resources
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Keywords
- intrauterine contraception, levonorgestrel-releasing intrauterine system, contraceptive recommendations, health care provider bias, race and ethnicity, socioeconomic status, health disparities, Hispanic women, Black patients, Caucasian patients
- MeSH terms
- Attitude of Health Personnel, Contraceptive Agents, Female, Female, Humans, Intrauterine Devices, Medicated, Male, Middle Aged, Risk Factors, Social Class, Videotape Recording, Levonorgestrel, Racial Groups
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