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Publications (5)17.56 Total impact

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    ABSTRACT: While much attention has been focused on unintended pregnancy in disadvantaged populations, few studies have focused on women in lower risk groups. This study, conducted in a national managed care organization, reports the prevalence of unintended pregnancy resulting in live births and examines associated factors Women ages 18-49 who delivered a live infant during a 6-month interval were eligible for the study. Telephone surveys were conducted after delivery. We report the rate of unintended pregnancy resulting in a live birth, and describe its association with sociodemographic and pregnancy-related factors, partner's intention status, and contraceptive use. Of 1173 births, 29% were unintended. Women who reported that the partner did not want the pregnancy were 7.4 times more likely than women whose partner wanted the pregnancy to regard the pregnancy as unintended. Only 40% of the women with an unintended birth used birth control and 64% of those used less effective methods such as condoms and diaphragms. In a population where the majority of women were married, educated, and with incomes over $40,000, almost 1/3 of the births resulted from unintended pregnancies. Future research is needed to help us better understand contradictions in pregnancy intention and contraceptive behavior. Comprehensive efforts are needed to promote consistent and correct use of contraception by women at risk for unintended pregnancy, and to involve male partners in family planning.
    Maternal and Child Health Journal 10/2002; 6(3):181-7. DOI:10.1023/A:1019778129435 · 2.24 Impact Factor
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    ABSTRACT: To evaluate the extent to which physician choice, length of patient-physician relationship, and perceived physician payment method predict patients' trust in their physician. Survey of patients of physicians in Atlanta, Georgia. Subjects were 292 patients aged 18 years and older. Scale of patients' trust in their physician was the main outcome measure. Most patients completely trusted their physicians "to put their needs above all other considerations" (69%). Patients who reported having enough choice of physician (p < .05), a longer relationship with the physician (p < .001), and who trusted their managed care organization (p < .001) were more likely to trust their physician. Approximately two thirds of all respondents did not know the method by which their physician was paid. The majority of patients believed paying a physician each time a test is done rather than a fixed monthly amount would not affect their care (72.4%). However, 40.5% of all respondents believed paying a physician more for ordering fewer than the average number of tests would make their care worse. Of these patients, 53.3% would accept higher copayments to obtain necessary medical tests. Patients' trust in their physician is related to having a choice of physicians, having a longer relationship with their physician, and trusting their managed care organization. Most patients are unaware of their physician's payment method, but many are concerned about payment methods that might discourage medical use.
    Journal of General Internal Medicine 10/1998; 13(10):681-6. DOI:10.1046/j.1525-1497.1998.00204.x · 3.45 Impact Factor
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    ABSTRACT: We conducted a telephone survey of female managed care enrollees who recently had a normal vaginal delivery to examine the relationship between hospital length-of-stay and maternal characteristics, pregnancy factors, length-of-stay preferences, and postdischarge experiences. Results indicated that length-of-stay varied by maternal characteristics and pregnancy factors. Length-of-stay and maternal or newborn readmissions were not statistically associated. Most respondents reported that they would be willing to go home within twenty-four hours after future deliveries if additional services were provided. Emphasis should be placed on which services can be provided to prepare and assist mothers through the perinatal period.
    Health Affairs 05/1997; 16(3):198-208. DOI:10.1377/hlthaff.16.3.198 · 4.97 Impact Factor
  • American journal of health promotion: AJHP 03/1997; 11(4):247-9. DOI:10.4278/0890-1171-11.4.247 · 2.37 Impact Factor
  • NA Davis · E Nash · C Bailey · M J Lewis · B K Rimer · J P Koplan
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    ABSTRACT: Mammography has been shown to reduce breast cancer mortality among women 50 and older. Although mammography rates are increasing nationally, this effective screening tool remains underused. This study was conducted among 395 women who were members of a network model health maintenance organization (HMO) in Philadelphia in order to determine which of three methods was most effective in increasing mammography rates: (1) a birthday card reminder only (the standard method); (2) a personalized letter from the medical director and materials promoting mammography; and (3) a multicomponent phone call incorporating a reminder, counseling, and scheduling of appointments. An additional goal was to determine whether the interventions were more or less effective depending on a woman's readiness to get a mammogram, as measured by stage of change. Eligible women were randomized into one of three treatment groups described earlier. Mammography rates were calculated on the basis of a claims review and follow-up phone interviews after a period of six months. Women who received the telephone intervention were most likely to obtain a mammogram (28%); followed by the group that received the birthday card only (15%), and those who received the mailed intervention (9%). These results indicate that a multicomponent phone intervention is significantly effective in promoting mammography in managed health care plan members. An analysis by women's stage of change found a difference in the effectiveness of the three interventions among contemplators only.
    American Journal of Preventive Medicine 01/1997; 13(4):298-302. · 4.53 Impact Factor