PDF(Pubmed)
Abstract：
Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a novel measure: the Coercion in Contraceptive Care Checklist. In early 2023, we surveyed reproductive-aged people in the United States who were assigned female at birth about their contraceptive care. We describe the frequency of contraceptive coercion in our sample (N = 1197) and use open-ended descriptions to demonstrate nuances in these experiences. Finally, we debut our checklist and present psychometric testing results. Among people who had ever talked to a healthcare provider about contraception, over one in six participants (18.46%) reported experiencing coercion during their last contraceptive counseling, and over one in three (42.27%) reported it at some point in their lifetime. Being made to use or keep using birth control pills was the most common form of coercion reported by patients (14.62% lifetime frequency). Factor analysis supported the two-factor dimensionality of the Coercion in Contraceptive Care Checklist. Inter-item correlations were statistically significant (p < 0.001), providing evidence of reliability. The checklist was also related to measures of quality in family planning care (downward coercion: t[1194] = 7.54, p < 0.001; upward coercion: t[1194] = 14.76, p < 0.001) and discrimination in healthcare (downward coercion: t[1160] = -14.77, p < 0.001; upward coercion: t[1160] = -18.27, p < 0.001), providing evidence of construct validity. Findings provide critical information about the frequency and manifestations of contraceptive coercion. Psychometric tests reveal evidence of the Coercion in Contraceptive Care Checklist\'s validity, reliability, and dimensionality while also suggesting avenues for future testing and refinement.
摘要：
尽管人们越来越担心避孕方面的胁迫，很少有研究描述了它的频率和表现。Further,没有确定的定量方法来测量这种结构。我们开始通过详细说明避孕胁迫经历的细微差别并测试一种新颖的措施来填补这一空白：避孕护理清单中的胁迫。在2023年初，我们调查了美国生育年龄的人，他们在出生时被分配给女性，了解他们的避孕护理。我们在样本中描述了避孕胁迫的频率（N=1197），并使用开放式描述来证明这些经验中的细微差别。最后,我们首次发布了检查表，并提供了心理测试结果。在曾经与医疗保健提供者谈论避孕的人中，超过六分之一(18.46%)的参与者报告说，在他们上次的避孕咨询中经历了胁迫，超过三分之一(42.27%)的人在他们一生的某个时候报告了这一情况。使用或继续使用避孕药是患者报告的最常见的胁迫形式（终生频率为14.62％）。因子分析支持避孕护理清单中强制的双因素维度。项目间相关性有统计学意义(p<0.001)，提供可靠性的证据。该清单还与计划生育护理的质量指标有关（向下胁迫：t[1194]=7.54，p<0.001；向上胁迫：t[1194]=14.76，p<0.001）和医疗保健中的歧视（向下胁迫：t[1160]=-14.77，p<0.001；向上胁迫：t[1160]=-18.27，p<0.001），提供结构效度的证据。研究结果提供了有关避孕胁迫的频率和表现的关键信息。心理测试揭示了避孕护理清单中强制性有效性的证据，可靠性,和维度，同时也为未来的测试和改进提供了途径。
