Trust in provider and racial/ethnic disparities in contraceptive method choice among young, low-income women

While long-acting reversible contraceptives (LARC) are high-efficacy, their provision can raise concerns about voluntary informed choice and trust in providers. We used data from a large, national study on contraceptive provision to examine racial/ethnic disparities in trust in provider, voluntary contraceptive decision-making, and LARC method choice. The study population is women, 18-25 years, who received contraceptive counseling (n=1,500) at 40 Planned Parenthood sites throughout the U.S. Our research question was whether trust in provider varied by race/ethnicity, and whether it was associated with contraceptive method choice. We used a validated version of a Trust in Physician scale. Over 99% of patients reported highly voluntary method choices, with no racial/ethnic differences. Trust in provider was also high overall, with African American women reporting significantly higher trust in providers than whites, although higher trust was not associated with choice of LARC methods. Multivariate logistic regression showed that Latinas were significantly more likely to choose LARC methods than whites (p=0.009), but this choice was not associated with provider trust (p=0.36). Trust and patient interaction are integral components of quality service provision. Results showed that providers successfully established trust with patients from all racial/ethnic communities, although patient choice of the higher efficacy methods did not increase with trust in provider. 12-month follow-up data from this ongoing study will show whether trust in provider is simply a foundation of high quality care, or whether it also bolsters method acceptability and continuation.