204162 Factors associated with family planning and vasectomy discussions: Results from a state-wide health provider survey

Monday, November 9, 2009

Ezekiel E. Young, MD, MA , Department of Urology, University of Miami Miller School of Medicine, Miami, FL
Brian Nguyen, MA , Warren Alpert Medical School, Brown University, Providence, RI
Nomi Weiss-Laxer, MPH, MA , School of Nursing and Health Studies, University of Miami, Miami, FL
Mark Sigman, MD , Department of Urology, Brown University, Providence, RI
Patricia Nolan, MD, MPH , Department of Community Health, Alpert Medical School, Brown University, Providence, RI
INTRODUCTION: Despite the relative advantages of vasectomy over tubal ligation, vasectomy is underutilized in the United States. Increased vasectomy uptake in the population may depend on the ability and willingness of health care providers to reorient men towards the positive aspects of vasectomy. Our study aimed to: 1) describe provider knowledge and attitudes regarding sterilization and 2) identify provider-related factors associated with discussions of family planning and vasectomy. METHODS: A one-time survey was mailed to a statewide sample of health care providers in the fields of internal medicine, family medicine, and obstetrics/gynecology. In addition to providing demographic information, providers reported on sterilization knowledge, patient resistance to vasectomy, and provider experiences discussing family planning. RESULTS: Of the providers who completed surveys (N=67), a greater proportion believed vasectomy to be underutilized (83.9%) compared to tubal ligation (23.9%). The most common reasons that providers felt their patients were disinclined to vasectomy included aversion to surgical procedure, desire for more children, satisfaction with other methods of contraception, and concerns about masculinity and sex life. T-tests revealed that compared to other providers, family medicine providers were more likely to discuss vasectomy (p=.013) and family planning (p<.001) with their male patients. In addition, compared to female providers, male providers were less likely to discuss family planning (p=.002) with their female patients. CONCLUSION: Our data suggest that provider gender (female) and specialization (family medicine) may be related to rates of family planning discussion. Further research may better characterize the provider and patient related factors preventing vasectomy uptake.

Learning Objectives:
1. Appreciate that vasectomy is widely underutilized despite its advantages to tubal ligation. 2. Recognize that both provider-related and patient-related factors contribute to the underutilization of family planning services and vasectomy. 3. Describe the knowledge and attitudes of healthcare providers towards sterilization and vasectomy. 4. Describe provider-related factors associated with higher rates of discussion of family planning and vasectomy. 5. Describe the reasons why providers think their patients are resistant to vasectomy.

Keywords: Male Reproductive Health, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have previous survey research experience and took part in the planning, implementation, and analysis of this research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.