Article Contraceptive Counseling in Managed Care: Preventing Unintended Pregnancy in Adults Carol S. Weisman, PhD Department of Health Management and Policy University of Michigan School of Public Health Ann Arbor, Michigan Deidre Spicer Maccannon, MD, MMgmt Department of Obstetrics and Gynecology University of Michigan Medical School Ann Arbor, Michigan Jillian T. Henderson, MPH Emily Shortridge Department of Health Management and Policy University of Michigan School of Public Health Ann Arbor, Michigan Camille L. Orso M-CARE Ann Arbor, Michigan Abstract This study examines contraceptive counseling received by adult women in their managed care plans and the relationship between counseling and women’s contraceptive attitudes and practices. Telephone interviews were conducted with a random sample of 898 women ages 18 to 44 enrolled in a commercial health maintenance organization (HMO) or point-of-service (POS) health plan. Counseling received in the past 2 years was measured on three dimensions: exposure through any communication channel; content of information; and personalization of discussion. Multiple logistic regression analysis was used to examine the determinants of counsel- ing and the relationship between counseling and four outcomes: satisfaction with counseling received, self-efficacy for preventing unintended pregnancy, current use of contraception (if at risk of unintended pregnancy), and intent to contracept in the next year (if at risk). Overall, 60.5% of women were at risk of unintended pregnancy; among those at risk, 69% received any counseling in the past 2 years, compared with 38% among those not at risk. Receiving personalized counseling (as opposed to no counseling or only informational counseling) significantly increases the odds of satisfaction with counseling, current contraceptive use, and intent to contracept. Informational counseling alone (without personalization) significantly increases the odds of contraceptive use. Women ages 40 – 44 were less likely than younger women to receive counseling and to use contraception if at risk of unintended pregnancy. We conclude that receiving contraceptive counseling in managed care is associated with contraceptive attitudes and practices among adults and that there is substantial room for quality improvement in the provision of contraceptive counseling. © 2002 by the Jacobs Institute of Women’s Health Published by Elsevier Science Inc. 1049-3867/02/$22.00 PII S1049-3867(01)00147-5 79 WEISMAN ET AL: CONTRACEPTIVE COUNSELING OF ADULT WOMEN