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.
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.
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.
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.
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Accepted: March 10, 2023
Received in revised form: March 3, 2023
Received: December 15, 2022
Publication stageIn Press Accepted Manuscript
© 2023 Published by Elsevier Inc.