Development of the Patient-Centered Contraceptive Counseling scale (PCCC), a short form of the Interpersonal Quality of Family Planning Care scale.

Abstract

OBJECTIVES\nPatient-centeredness is a critical component of quality in family planning. We previously validated an 11-item Interpersonal Quality of Family Planning (IQFP) scale. We sought to create a parsimonious version of the scale in preparation for testing its appropriateness as a patient-reported outcome performance measure (PRO-PM).\n\n\nSTUDY DESIGN\nTo explore clarity and importance of each of the 11 items, we conducted English and Spanish cognitive interviews with patients who received contraceptive counseling (n=33) at three publicly-funded California clinics. We triangulated these results with psychometric analysis of previously collected IQFP data (n=1,097) to assess validity and reliability of selected item combinations.\n\n\nRESULTS\nThe 11-item IQFP scale was reduced to a 4-item scale (the Patient-Centered Contraceptive Counseling scale, or PCCC) that includes items evaluating provider performance regarding respect for patients, information provision, and eliciting and honoring patient preferences for birth control. Interview participants deemed the items included in the 4-item PCCC important and clear in both English and Spanish versions of the instrument. The 4-item PCCC retained the 11-item IQFP s psychometric properties, including internal consistency (Cronbach s alpha\u202f=\u202f0.92 vs. 0.97 for the PCCC and IQFP, respectively) and a consistent single factor analysis solution (factor loadings\u202f=\u202f.86-.92 and .81-.91). The 4-item PCCC additionally retained the construct and predictive validity of the IQFP.\n\n\nCONCLUSIONS\nThe 4-item PCCC is a valid and reliable as a measure of patient-centered contraceptive counseling that reflects patients perspectives on contraceptive counseling.\n\n\nIMPLICATIONS\nPatient-centered measures such as the 4-item PCCC can help inform efforts to improve health care quality. Future work will investigate the validity and reliability of the 4-item PCCC as a performance measure to determine the appropriateness of its use in the quality improvement context.