Measuring the Person-Centeredness of Contraceptive Care 

The development of the Person-Centered Contraceptive Care measure (PCCC) involved refining the 11-item IQFP into a shorter, yet still valid and reliable measure. This process utilized a combination of qualitative and quantitative methods, including factor analysis to identify patterns and describe variability, and cognitive interviewing to refine questionnaire design. After confirming the measure’s face validity to align with the perspectives of patients, providers, and clinic administrators, a pilot test was conducted across the U.S. to assess the PCCC’s effectiveness as a Patient-Reported Outcome Performance Measure (PRO-PM) at the provider and clinic levels. Additionally, a patient stakeholder group from the Bay Area provided ongoing feedback and guidance throughout the development process. The PCCC was endorsed by the National Quality Forum (now PQM) in 2020 and is being used in many health networks and clinics across the country.  

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Retrospective PCCC 

While the PCCC has been validated and endorsed as a measure to be administered at the time of service, there is a need for a measure that can be used by larger networks, insurance plans and accountability programs that can be administered looking back over a specific time period, for example 6 months or a year. PCRHP conducted a modified Delphi process to engage stakeholders in reviewing and modifying the PCCC to work in this new context. Dubbed the PCCC-RS, this new measure is now being tested for validity and reliability with the goal of submitting it to PQM for endorsement.  

Creating person-centered quality measures of contraceptive use 

Many people, particularly women of color and those from lower socioeconomic backgrounds, face difficulties in accessing family planning services. Previous efforts to assess contraceptive access were flawed because they included “all women” seen at a clinic within a year. This lack of precision often resulted in coercive counseling practices. To address this, PCRHP developed a more precise measure that focuses only on those people interested in contraceptive services. Utilizing the SINC screening question in its methodology, PCRHP developed the next generation of contraceptive provision measures—Contraceptive Use electronic clinical quality measures (CU-CQMs). As part of the ICC in CHC project, PCRHP was able to perform validity and reliability testing on CU-eCQMs and SINC as a standalone performance measure called the Contraceptive Care Screening eCQM (CCS-eCQM). Contraceptive Use eCQMs (previously called SINC-based eCQMs) are endorsed by PQM. PCRHP is currently conducting validity and feasibility testing onthe CCS eCQM performance measure and plans to submit to PQM for endorsement in Fall 2024. We continue to pursue funding for implementation research on how to best implement these measures in health centers.  

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Self-Assessed Pregnancy Acceptability (SAPA)  

Unintended pregnancy is a limited measure that doesn’t reflect the diversity of individuals’ lived experiences. This study aims to develop a new, multidimensional measure of self-assessed pregnancy acceptability that more accurately reflects the complex factors influencing pregnancy, childbearing, and reproductive outcomes. We created a conceptual model based on in-depth interviews and cognitive testing with individuals who recently discovered they were pregnant, along with insights from an expert panel. We then developed a quantitative measure that we are currently testing with 540 participants from Pennsylvania, California, and Tennessee.

This study is led by Dr. Sonya Borrero at the University of Pittsburgh and funded by the National Institute of Child Health and Human Development. 

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Sexual and Reproductive Wellbeing Measure 

Wellbeing is increasingly recognized as a desirable outcome that governments and policymakers should both measure and prioritize. However, sexual and reproductive health has often been left out of the well-being discussion. Over the last few years, PCRHP and partners, both within the US and globally, have worked to create a conceptual framework and definition of what is sexual and reproductive wellbeing.  Phase 2 of this important work will include drafting a preliminary instrument, testing and refining the instrument and developing recommendations for use.  

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