Patient and counselor satisfaction with structured contraceptive counseling by health center staff in federally qualified health centers.

Abstract Objectives: To characterize patient and counselor satisfaction with structured, tier-based contraceptive counseling provided by a non-clinician. Study Design: We conducted a planned secondary analysis of patient and counselor surveys from a study that enrolled women in two contraceptive care programs. All participants received structured contraceptive counseling from trained staff members. Women and counselors completed a confidential post-visit survey regarding satisfaction with counseling and medical mistrust. We used univariate and multivariable regressions to examine differences in high satisfaction with counseling (top score), perceived counselor influence, and perceived counselor judgment by participant characteristics. Results: 942 participants completed surveys; most reported they felt respected (100.0%), trusted the counseling information (99.5%), and that counseling helped them choose a contraceptive method (83.8%). Black race, high school education, public insurance, an income below the federal poverty level, and enrollment site were associated with high medical mistrust. Participants with high medical mistrust were less likely to be highly satisfied with counseling (RRadj 0.72; 95% CI 0.63-0.82), more likely to perceive influence (RR 1.77; 95% CI 1.37-2.28), and more likely to perceive judgment (aOR 8.91; 95% CI 3.61-22.01). Mostly, counselors felt they were able to answer participant questions (98.8%), establish good rapport (95.9%), and that participants understood the information presented (98.0%). Most participants reported the information helpful in choosing a method (83.8%). Conclusions: Overall, participants were satisfied with tier-based contraceptive counseling delivered by non-clinician staff members. Those with high levels of medical-mistrust were less likely to be satisfied. The majority of women found the information beneficial in contraceptive decision making.