Abstract
Objective
A performance measure assessing how often patients experience patient-centered contraceptive
counseling can inform quality improvement in contraceptive care and enable efforts
to enhance equity in the provision of this care. We sought to test the validity and
reliability of the Person-Centered Contraceptive Counseling (PCCC) measure as a performance
measure, in preparation for application for endorsement from the National Quality
Forum.
Study Design
We combined data from two research studies, a statewide quality improvement assessment,
and a dedicated data collection effort at nine sites, all collected between 2009 and
2019 at 22 total sites in the United States, to evaluate the validity and reliability
of a the four-item PCCC measure aggregated at the provider and facility level. We
scored the PCCC dichotomously as a "top-box" score of 20 versus less than 20. We assessed
reliability using the Spearman-Brown coefficient, and validity by comparing scores
on the PCCC to aggregated scores on single-item measures of patient satisfaction.
Results
We included 22 facilities and 34 providers in analyses. The average PCCC top-box score
by provider and facility was 81% and 79% respectively. We found adequate reliability
with panel sizes of 20-50. PCCC scores were strongly associated with the single-item
measures of satisfaction. There were notable disparities by race/ethnicity and language
(Spanish vs. English) in PCCC scores.
Discussion
The PCCC is a valid and reliable performance measure for use at the provider and facility
level. Use of this measure can facilitate the identification of gaps in patient-centered
contraceptive counseling and enable quality improvement to promote quality, equitable
contraceptive care.
Keywords
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Article info
Publication history
Accepted:
March 10,
2023
Received in revised form:
March 3,
2023
Received:
December 15,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Published by Elsevier Inc.
