Current Projects

Select Past Projects

Abortion hub: Online Pregnancy Options Information for US Adolescents and Young Adults

Project Dates: 

Funded by a private funder and conducted in collaboration with our Bixby Center colleagues, the purpose of this project is to develop a comprehensive, trustworthy website about abortion for teens and young adults in the U.S. The project leverages UCSF’s expertise in abortion research and advocacy, and is strengthened by engagement with abortion providers and youth stakeholders. Our team has convened a Youth Advisory Board comprised of passionate teens and young adults living in the Bay Area, who represent a range of identities and experiences, and will ensure the implementation of a youth-driven approach that prioritizes inclusivity in the development of the site’s branding, design and content.

Adaptation and Dissemination of the Quality of Contraceptive Counseling Scale

Project Dates: 2018 - 2021

The Quality of Contraceptive Counseling (QCC) Scale was developed to improve measurement of quality and human rights in contraceptive care. The scale has three related dimensions—Information Exchange, Interpersonal Relationship, and Disrespect and Abuse—that cover a broader construct than is typically captured in client survey instruments. The scale was based on formative research conducted on preferences for contraceptive counseling in Mexico*, and was found to be valid and reliable for use in Mexico**. In partnership with researchers in Mexico, India, and Ethiopia, our team is now adapting the QCC Scale for broader use and conducting qualitative research with representatives of public healthcare systems in these countries to inform future work to implement the QCC Scale as a quality improvement/rights monitoring tool.

See Publication: Development and Validation of the Client‐Reported Quality of Contraceptive Counseling Scale to Measure Quality and Fulfillment of Rights in Family Planning Programs

Adolescent Health Website: Laying the Foundation for Healthy Reproduction: A Lifecourse Approach to Prevention of Preterm Birth through Engaging and Empowering Adolescents

Project Dates: 

Funded by the California Preterm Birth Initiative at UCSF, this project seeks to develop and evaluate an educational website meant to equip adolescents with the knowledge, resources, and support necessary to engage with their healthcare. PCRHP is engaging with a Youth Advisory Board who will provide ongoing, vital feedback on the scope and design of the intervention throughout the course of the project. A randomized controlled trial will be conducted in order to evaluate the intervention's impact on adolescents' knowledge, behavior, and self-efficacy related to healthy outcomes and health care-seeking behavior.

Advancing measurement in contraceptive care: testing and application for endorsement of electronic clinical quality measures (eCQMs) for contraceptive provision

Project Dates: 2019 - 2022

Funded by the Office of Population Affairs, the goal of this project is to enhance the quality of contraceptive services, particularly in underserved populations, through widespread use of validated performance measures for contraceptive care in diverse care contexts, including Community Health Centers (CHCs). In collaboration with Far Harbor, a statistical consulting group, the project team will use data from electronic health records of Health Center Controlled Networks (HCCNs) to perform validity and reliability testing of the novel set of electronic clinical quality measures (eCQMs) of contraceptive provision. These measures will seek to answer the question, of those who want contraceptive services, how many are provided a method of contraception? The denominator of these novel eCQMs will incorporate a new screening question in primary care settings to assess patients’ desire for contraceptive services that day. The objectives of this project are to achieve National Quality Forum (NQF) endorsement for eCQMs and to prepare for dissemination of these measures alongside a patient-reported outcome performance measure (PRO-PM) that measures patient-centeredness in contraceptive counseling.

California Preterm Birth Initiative (PTBi) Systematic Review

Project Dates: 2019 - 2021

Contraceptive counseling during the peripartum period is an important component of comprehensive peripartum care. By enabling women to use their desired birth control method after delivery, contraceptive counseling can impact birth spacing and thus key maternal and child health outcomes. However, the peripartum period is a challenging time to provide contraceptive care because women and providers are focused on the current state of the pregnancy – prenatal health and preparing for birth, or recovery and newborn care – more than the question of potential future pregnancies. 

Research suggests that women prefer counseling and decision support throughout the peripartum period that is personalized to meet their individual needs. Therefore, innovative approaches are needed to support quality individualized contraceptive counseling and provision during this time. The quality of contraceptive counseling has important implications for women’s experiences of family planning care and reproductive health outcomes; whether or not women receive care that supports their autonomy and decision making has implications for women’s trust in reproductive health providers and access to reproductive health care in both the short and long term. 

Creating and implementing innovative approaches to peripartum counseling requires an understanding of the current state of knowledge and action in this area. Existing research on peripartum contraceptive counseling and what interventions exist for peripartum contraceptive care has yet to be compiled and synthesized in a systematic manner. 

This systematic review aims to understand women’s experiences with and preferences for contraceptive care during the peripartum period, as well as synthesize the research about counseling interventions delivered during the peripartum period.

Development and dissemination of person-centered approaches to contraceptive care

Project Dates: 2018 - 2022

The goal of this project is to promote a focus on principles of equity and person-centeredness in contraceptive access work in the United States. In the first phase of this project, our team developed the Person-Centered Contraceptive Care (PCCC) Framework* to serve as a blueprint for policymakers, program implementers, and researchers to consider a broad range of factors influencing equitable access to high-quality, person-centered contraceptive care and identify potential solutions.  With Mississippi Black Women’s Roundtable and other researcher and advocate partners in Mississippi,  we also conducted qualitative research with women in Mississippi (MS) to explore their reproductive healthcare needs and experiences along the continuum of the PCCC Framework. In the second phase of the project, we aim to: 1) Continue to disseminate and operationalize the PCCC Framework, 2) Develop and support the piloting of a Person-Centered Contraceptive Care Training (PCCCT) and Train the Trainer Program (TTTP) with the Mississippi contraceptive access program Converge, and 3) Disseminate research on the contraceptive care needs and experiences of reproductive-aged women in MS in collaboration with local partners.

See Publication: Beyond same-day long-acting reversible contraceptive access: a person-centered framework for advancing high-quality, equitable contraceptive care

Innovating Performance Measures in Community Health Center Quality Improvement Efforts (“Tandem Use Project”)

Project Dates: 2019 - 2022

The PCRHP is collaborating with the National Association of Community Health Centers (NACHC) to leverage the existing infrastructure and QI efforts in 40 – 44 Community Health Centers (CHCs) with national representation to develop the infrastructure and capacity for “tandem measurement” of electronic clinical quality measures (eCQMs) of contraceptive provision and a patient-reported outcome performance measure (PRO-PM) of patient experience of contraceptive counseling, the Person-Centered Contraceptive Counseling Measure (PCCC).  The eCQMs of contraceptive provision will focus on whether patients interested in contraceptive services are having their needs met at a CHC through the implementation of a new screening question developed in year 1 of this project. This screening question will be implemented in primary care settings, and asks patients if they want to talk about contraception or pregnancy prevention during their visit. The PCRHP and NACHC will leverage leading-edge health information technology (HIT) and practice support to enable efficient data collection and integration of results into QI efforts at the CHC level. This project will lay the groundwork for integrated use of the two measures and provide the opportunity to achieve robust quality improvement (QI) directed at both improved clinical outcomes and the quality of patient experience.

Leveraging Family Medicine's Core Values to Increase Access to Medication Abortion in The United States

Project Dates: 2018 - 2021

Funded by the Society for Family Planning, our multidisciplinary team of clinicians, researchers, educators, advocates, and communication specialists is developing communication strategies aimed at motivating and supporting family physicians to provide medication abortion in primary care. We conducted interviews with family medicine physicians and trainees to assess their perspectives on the relationship between the core values of family medicine and the provision of medication abortion and explore potential mechanisms and messaging to draw on these values to increase medication abortion provision. We then developed communication strategies based on the findings of these interviews and conducted cognitive interviews and surveys to evaluate materials with practicing family physicians, Family Medicine faculty and residents, and patients. The final product will be a refined set of communication strategies intended to motivate medication abortion provision among family physicians.

My Birth Control: A contraception decision-support tool

Project Dates: 

Funded by the Patient-Centered Outcomes Research Institute (PCORI), this project involved the development of a tablet-based contraceptive decision support tool for women and a large-scale, longitudinal randomized control trial to test its effectiveness in four clinics in San Francisco. The tool has been demonstrated to improve patient experience of contraceptive counseling, contraceptive knowledge and decision quality, without increasing the time providers spend with patients. My Birth Control is being disseminated at this time, and adaptations have been made for the peripartum context and abortion care.

My Decision: Developing and testing a decision support tool for women making decisions about postpartum tubal sterilization

Project Dates: 2017 - 2023

Funded by the National Institute on Minority Health and Health Disparities, our research team in collaboration with Dr. Sonya Borrero at the University of Pittsburgh seeks to support low-income women’s needs and preferences for sterilization decision support that aligns with their preferences, values, and reproductive goals. Through a multi-site (Pittsburgh, PA; Knoxville TN; and San Francisco, CA) randomized controlled trial, we will test the efficacy of a web-based decision aid we have created among low-income women requesting post-partum sterilization with respect to knowledge, decisional conflict, selection of sterilization versus an alternative reversible contraceptive method, and satisfaction with their decision.

Socialization of the Person-Centered Contraceptive Counseling measure (PCCC)

Project Dates: 2021 - 2021

The Person-Centered Contraceptive Counseling measure (PCCC) is a patient-reported outcome performance measure (PRO-PM) of contraceptive counseling developed from quantitative and qualitative research of women’s preferences for contraceptive counseling. The PCRHP found the measure to be valid and reliable through a real-world pilot test conducted between 2017 and 2019. The National Quality Forum (NQF) endorsed the measure for use at the provider and facility-level in 2020. The measure can be used as a standalone measure of patient experience, or as a balancing measure to the contraceptive provision measures developed by the Office of Population Affairs. Learn more about the PCCC here: The PCRHP received a grant through the Coalition to Expand Contraceptive Access (CECA) to disseminate and socialize the measure with key stakeholders and support its use in clinics and health systems nationwide. The information gathered during this one-year project will assist with the 3-year maintenance application required for continued NQF endorsement.

Putting the focus on women’s contraceptive counseling experiences

Project Dates: 2016 - 2020

Patient-centeredness in contraceptive counseling is essential to quality family planning care. In 2016, PCRHP began work on a four-year project to refine and test a Patient-Reported Outcome Measure (PROM) and Patient-Reported Outcome Performance Measure (PRO-PM) to understand patients’ experiences of contraceptive counseling and inform improvements to counseling practices. The PROM and PRO-PM is based on the Interpersonal Quality of Family Planning Care (IQFP) scale previously developed by Dr. Dehlendorf. The 11-item IQFP was reduced to a 4-item scale using qualitative and quantitative data. The PCRHP conducted a real-world pilot test of the 4-item scale as a PRO-PM between 2017 and 2019. The team found the PRO-PM is both valid and reliable, and subsequently applied for National Quality Forum (NQF) endorsement of the measure. NQF endorsed the measure for use at the provider and facility-level in November 2020. The final PRO-PM, the Person-Centered Contraceptive Counseling Measure (PCCC), is available for use in research and quality improvement settings.

Identifying Strategies to Improve the Family Planning Experiences of Peripartum Women

The UCSF Preterm Birth Initiative California (PTBi-CA) focuses on discovering and enacting innovative approaches to improve birth outcomes for women and infants in San Francisco, Oakland, and Fresno. PCRHP began work with PTBi-CA in 2016 to explore how family planning care might play a role in narrowing San Francisco’s preterm birth disparities. PCRHP will engage community stakeholders and conduct formative work around women of color’s attitudes and preferences for perinatal family planning care and contraceptive counseling. Results will potentially inform the development of an intervention to improve the family planning experiences of peripartum women at risk for preterm birth.

My Birth Control: Development of a Decision Support Tool for Contraception

Funded by the Patient-Centered Outcomes Research Institute (PCORI), this project involves the development of a tablet-based contraceptive decision support tool for women and a large-scale, longitudinal randomized control trial to test its effectiveness in four clinics in San Francisco. The My Birth Control tool was designed by PCRHP in collaboration with designers from The trial will inform PCRHP'S plan to disseminate the tool for wider use in diverse family planning care settings.

SpeakOut: Harnessing the Power of Social Networks to Disseminate Contraceptive Information among Adolescents

In 2015, PCRHP received a 5-year grant from the Office of Adolescent Health to develop, rigorously evaluate, and disseminate SpeakOut, a social communication intervention about intrauterine devices (IUDs) and subdermal contraceptive implants for adolescents age 15 to 19. As friends and family members are valuable sources of contraceptive information for young people, SpeakOut encourages IUD and implant users to share their experiences so that their peers can be informed and empowered to make their own decisions about these methods. SpeakOut includes a clinic session, pamphlets, website, and text messages and is based on the intervention WhyIUD, previous piloted by PCRHP.

Birth Control Connect: Online Peer Influence on IUD Behaviors and Attitudes

A collaboration between PCRHP and researchers at the University of Pennsylvania Annenberg School of Communication, this study will investigate a possible association between women’s social exposure to intrauterine device (IUD) users in an online social network, and change in attitudes and behaviors related to IUD use. The study is funded by the Hewlett Foundation.

Contraceptive Counseling and Women’s Contraceptive Experiences

PCRHP is currently analyzing data from a cohort study investigating contraceptive counseling, which involved audiorecording over 300 contraceptive counseling visits and followed women for six months after their visit to explore women’s experiences of contraceptive counseling and to determine what aspects of counseling are associated with satisfaction with family planning care and with contraceptive continuation.