David J. Landry

Guttmacher Institute, New York City, New York, United States

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Publications (3)6.18 Total impact

  • David J Landry, Junhow Wei, Jennifer J Frost
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    ABSTRACT: This study measured differences in the provision of care between public and private providers of contraceptive services, what problems using contraception these providers perceived their patients to have and providers' views on how to improve their patients' method use. A nationally representative mixed-mode survey (mail, Internet and fax) of private family practice and obstetrician/gynecologist physicians who provided contraceptive care in 2005 was conducted. A parallel survey was administered to public contraceptive care providers in community health centers, hospitals, Planned Parenthood clinics and other sites during the same period. Descriptive and multivariate analyses were conducted across both surveys. A total of 1256 questionnaires were completed for a response rate of 62%. A majority of providers surveyed believed that over 10% of their contraceptive clients experienced ambivalence about avoiding pregnancy, underestimated the risk of pregnancy and failed to use contraception for one or more months when at risk for unintended pregnancy. Implementation of protocols to promote contraceptive use ranged widely among provider types: a full 78% of Panned Parenthood clinics offered quick-start pill initiation, as did 47% of public health departments. However, 38% of obstetrician-gynecologists, 27% of "other public" clinics and only 13% of family physicians did so. Both public and private providers reported that one of the most important things they could do to improve patients' contraceptive method use was to provide more and better counseling. At least 46% of private providers and at least 21% of public providers reported that changing insurance reimbursement to allow more time for counseling was very important. Strategies to improve contraceptive use for all persons in need in the United States have the potential to be more effective if the challenges contraceptive providers face and the differences between public and private providers are taken into account.
    Contraception 08/2008; 78(1):42-51. · 3.09 Impact Factor
  • Jennifer J. Frost, David J. Landry
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    ABSTRACT: Objectives: Unintended pregnancy and contraceptive failure continue to be significant problems in the U.S. today. By comparing information obtained from women about their difficulties using methods successfully with information from providers about their services and perceptions of women's needs, we have developed recommendations for improving contraceptive service provision. Methods: We conducted nationally representative surveys of women and of contraceptive service providers. The women's sample was generated through random-digit-dialing and 1,978 eligible women were interviewed over the phone. The provider samples were drawn from lists of obstetrician/gynecologist and family practice physicians and publicly funded family planning clinics. Mailed questionnaires were collected from 382 private physicians and 805 clinics. Descriptive and multivariate analyses were conducted for each survey and the results compared across surveys. Results: Both women and providers report that inconsistent method use is common and that some women experience periods of contraceptive nonuse while remaining at risk for unintended pregnancy. Although women report that method dissatisfaction often precedes gaps in use, not all providers discussed these difficulties with patients. Other factors identified by women as contributing to difficultiesfor example, motivation to prevent pregnancy, life changes, and method side effectswere discussed by some, but not all, providers during contraceptive visits. Conclusions: The findings suggest a number of strategies that have the potential to help women improve their ability to use contraception consistently and correctly. Specific recommendations are presented within each of the following categories: counseling and follow-up; clinical practices; information and education; access and funding; and technology and training.
    135st APHA Annual Meeting and Exposition 2007; 11/2007
  • David Landry, Junhow Wei, Jennifer J. Frost
    Contraception 08/2007; 76(2):176-176. · 3.09 Impact Factor

Publication Stats

30 Citations
6.18 Total Impact Points

Top Journals

Institutions

  • 2007–2008
    • Guttmacher Institute
      New York City, New York, United States