Understanding contraceptive decision-making, use and pregnancy outcomes

We study women's and men’s knowledge and perceptions of different methods of contraception, preferences and method choice, contraceptive use and continuation, and pregnancy and other health, economic and social outcomes, especially for underserved populations including adolescents. Our research informs public policy and programmatic efforts to promote contraceptive awareness, access, reproductive autonomy and healthy equity.

We employ mixed methods, including survey research, medical record review, focus groups, in-depth interviews and policy analysis, to identify gaps in knowledge and to better understand patient preferences and the factors that influence contraceptive decision-making, including the role of health care providers, male partners and social support. We investigate differences in effective contraceptive use and pregnancy outcomes by race, ethnicity, age and socioeconomic groups. Understanding these complex issues is essential to the development of effective programs and policies to reduce health disparities and improve public health outcomes.


Selected Publications

  • Women's and men’s knowledge, decision-making and acceptability of contraception
  • Contraceptive use and pregnancy outcomes

Women's and men’s knowledge, decision-making and acceptability of contraception

  1. Steinberg JR, Tschann JM, Furgerson D, Harper CC. Psychosocial factors and pre-abortion psychological health: The significance of stigma. Social Science & Medicine 150:67-75, 2016.
  2. Raine-Bennett TR, Rocca CH. Development of a brief questionnaire to assess contraceptive intent. Patient Education and Counseling 98(11):1425-30, 2015.
  3. Steinauer J, Upadhyay U, Sokoloff A, Harper CC, Diedrich JT, Drey EA. Choice of the levonorgestrel intrauterine device, etonogestrel implant or depot medroxyprogesterone acetate for contraception after aspiration abortion. Contraception 9(6):553-559, 2015.
  4. Craig A, Dehlendorf C, Borrero S, Harper CC, Rocca CH. Exploring young adults' contraceptive knowledge and attitudes: Disparities by race/ethnicity and age. Women's Health Issues 24(3):281-9, 2014.
  5. Steinberg JR, Tschann JM, Henderson JT, Drey EA, Steinauer JE, Harper CC. Psychological distress and post-abortion contraceptive method effectiveness level chosen at an urban clinic. Contraception 88(6):717-24, 2013.
  6. Harper CC, Brown BA, Foster-Rosales A, Raine TR. Hormonal contraceptive method choice among young, low-income women: How important is the provider? Patient Education and Counseling 81:349-354, 2010.
  7. Raine TR, Gard J, Boyer CB, Haider S, Brown BA, Hernandez FAH, Harper CC. Contraceptive decision-making in sexual relationships: Young men’s experiences, attitudes and values. Culture, Health and Sexuality 12:373-386, 2010.
  8. Raine, TR, Epstein LB, Harper CC, Brown BA, Boyer CB. Attitudes towards the vaginal ring and transdermal patch among adolescents and young women. Journal of Adolescent Health 45:262-267, 2009.
  9. Stewart FH, Brown BA, Raine TR, Weitz TA, Harper CC. Adolescent and young women’s experience with the vaginal ring and oral contraceptive pills. Journal of Pediatric and Adolescent Gynecology 20:345-351, 2007.
  10. Foster DG, Ralph L, Arons A, Brindis C, Harper CC. Trends in knowledge of emergency contraception among women in California, 1999-2004. Women’s Health Issues 17:22-28, 2007.

Contraceptive use and pregnancy outcomes

  1. Rocca CH, Harper CC, Raine TR. Young women’s perceived benefits of childbearing: association with subsequent contraceptive use and pregnancy. Perspectives on Sexual and Reproductive Health 45:23–32, 2013.
  2. Rocca CH, Harper CC. Do racial and ethnic differences in contraceptive attitudes and knowledge explain disparities in method use? Perspectives on Sexual and Reproductive Health 44:150-158, 2012.
  3. Raine TR, Foster-Rosales A, Upadhyay U, Boyer CB, Brown BA, Sokoloff A, Harper CC. One-year contraceptive continuation and pregnancy in adolescent and young women initiating hormonal contraceptives. Obstetrics & Gynecology 117:363-71, 2011.
  4. Thompson KMJ, Foster Green D, Harper CC. Increased use of intrauterine contraception in California, 1997-2007. Women's Health Issues 21:425-30, 2011.