Rosenfeld Elian, Callegari Lisa S, Sileanu Florentina E, Zhao Xinhua, Schwarz E Bimla, Mor Maria K, Borrero Sonya
Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, University Drive (151C), Pittsburgh, PA 15240.
Health Services Research and Development, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108; Department of Obstetrics & Gynecology, University of Washington School of Medicine, Box 356460, Seattle, WA 98195-6460.
Contraception. 2017 Jul;96(1):54-61. doi: 10.1016/j.contraception.2017.03.008. Epub 2017 Mar 18.
To assess whether racial/ethnic disparities in contraceptive knowledge observed in the general US population are also seen among women Veterans served by the Veterans Affairs (VA) healthcare system.
We analyzed data from a national telephone survey of 2302 women Veterans aged 18-44 who had received care within VA in the prior 12 months. Twenty survey items assessed women's knowledge about various contraceptive methods. Multivariable logistic regression was used to examine racial/ethnic variation in contraceptive knowledge items, adjusting for age, marital status, education, income, parity, and branch of military service.
Contraceptive knowledge was low among all participants, but black and Hispanic women had lower knowledge scores than whites in almost all knowledge domains. Compared to white women, black women were significantly less likely to answer correctly 15 of the 20 knowledge items, with the greatest adjusted difference observed in the item assessing knowledge about the reversibility of tubal sterilization (adjusted percentage point difference (PPD): -23.0; 95% CI: -27.8, -18.3). Compared to white women, Hispanic women were significantly less likely to answer correctly 11 of the 20 knowledge items, with the greatest adjusted difference also in the item assessing tubal sterilization reversibility (PPD: -13.1; 95% CI: -19.5, -6.6).
Contraceptive knowledge among women Veterans served by VA is suboptimal, especially among racial/ethnic minority women. Improving women's knowledge about important aspects of available contraceptive methods may help women better select and effectively use contraception.
Providers in the VA healthcare system should assess and address contraceptive knowledge gaps as part of high-quality, patient-centered reproductive health care.
评估在美国普通人群中观察到的避孕知识方面的种族/族裔差异在接受退伍军人事务部(VA)医疗系统服务的女性退伍军人中是否也存在。
我们分析了一项对2302名年龄在18 - 44岁、在过去12个月内在VA接受过护理的女性退伍军人进行的全国电话调查数据。20个调查项目评估了女性对各种避孕方法的知识。多变量逻辑回归用于检验避孕知识项目中的种族/族裔差异,并对年龄、婚姻状况、教育程度、收入、生育次数和军种进行了调整。
所有参与者的避孕知识水平都较低,但几乎在所有知识领域,黑人和西班牙裔女性的知识得分都低于白人女性。与白人女性相比,黑人女性在20个知识项目中有15个正确回答的可能性显著更低,在评估输卵管绝育可逆性的项目中观察到的调整后差异最大(调整后的百分点差异(PPD):-23.0;95%置信区间:-27.8,-18.3)。与白人女性相比,西班牙裔女性在20个知识项目中有11个正确回答的可能性显著更低,在评估输卵管绝育可逆性的项目中调整后差异也最大(PPD:-13.1;95%置信区间:-19.5,-6.6)。
VA服务的女性退伍军人的避孕知识不理想,尤其是在种族/族裔少数群体女性中。提高女性对现有避孕方法重要方面的知识可能有助于女性更好地选择和有效使用避孕措施。
VA医疗系统的提供者应评估并解决避孕知识差距,将其作为高质量、以患者为中心的生殖健康护理的一部分。