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Association of Trust and Locus of Control with Postpartum Contraception Choice

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Objective: In this study, we explored associations of trust in the healthcare system, health locus of control, and patient factors with choice of effective postpartum contraception. Methods: For this observational study, we measured trust in the healthcare system and health locus of control using validated scales. The primary outcome was postpartum contraceptive choice. We defined effective contraception as methods with failure rate ≤ 10%. We used bivariate and multivariate analyses to determine associated variables. Results: Neither trust in the healthcare system nor health locus of control were associated with effective contraceptive choice. Black women were more likely to report choice of effective contraception compared to white women (OR = 4.26, 95% CI 1.43, 12.68). Choice of effective contraception did not differ between women who intended to become pregnant again in less than 2 years versus greater than 2 years although women with no desire for future pregnancy were more likely to choose effective methods (OR = 4.78, 95% CI 1.56, 14.64). Conclusions: Neither trust nor health locus of control were associated with choice of effective postpartum contraception. The increased likelihood of effective post-partum contraception in black women suggests coercion and bias in counseling and provision.
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Document Type: Research Article

Affiliations: 1: Angela Dempsey, Professor, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC;, Email: [email protected] 2: Jenna MacLennan, Attending Physician, McLeod ObGyn Associates, Florence, SC 3: Anna Nutter, Attending Physician, University of Texas Medical Branch, Galveston, TX 4: Rachel Stacey, Attending Physician, Kaiser Permanente, Denver, CO 5: Dulaney Wilson, Epidemiologist, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC

Publication date: July 1, 2020

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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