• Martina T Caldwell, Nanci Hambrick, Phyllis Vallee, Celia S D Thomas, April Sutton, Gwendolyn Daniels, Nikhil Goyal, Jacob Manteuffel, JosephChristine L MCLMDepartment of Public Health Sciences, Henry Ford Health System, Detroit, MI., and Timothy C Guetterman.
• Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI. Electronic address: mcaldwe2@hfhs.org.
• Ann Emerg Med. 2020 Oct 1; 76 (4): 515-526.

Study ObjectiveWe explore reproductive-aged women's acceptance of contraception counseling in the emergency department (ED).MethodsThis study is phase 1 of an exploratory sequential mixed methods study. We purposively interviewed 31 participants with the following criteria: black, white, or Latina race/ethnicity; nonpregnant; aged 15 to 44 years; receiving nonemergency care; not using highly effective contraception; and did not intend to become pregnant. We conducted semistructured interviews with a piloted interview guide until reaching thematic saturation. We coded transcripts with an iteratively developed codebook, maintaining intercoder agreement greater than 80%. Qualitative acceptance of ED contraception counseling was grouped into 3 categories: acceptable, unacceptable, and equivocal. We conducted a thematic text analysis to assess themes expressing support and concern for ED contraception counseling. Qualitative findings were stratified by age, race, and frequency of ED use. Using components of grounded theory, we developed a conceptual model.ResultsMost participants (81%) accepted ED contraception counseling. Themes expressing support and concern for ED contraception counseling included opportunity to address women's unmet contraception needs, contraception is within the scope of ED practice, the ED is a convenient setting with competent providers, contraception is a sensitive topic, and the ED may be an inappropriate setting for some women. Latina participants had lower acceptance of ED contraception counseling. Dominant subthemes varied slightly by race, age, and frequency of ED use.ConclusionDiverse women had high acceptance of contraception counseling in the ED. Perspectives expressing both support and concern in regard to ED contraception counseling were explored in detail.Copyright © 2019 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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