Understanding contraceptive decision-making, use and pregnancy outcomes

We study people'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. Our research informs public policy and programmatic efforts to promote contraceptive awareness, access, reproductive autonomy, and health equity.

We employ mixed methods, including survey research, medical records 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, partners, and social support. We investigate disparities in contraceptive use and pregnancy outcomes by age, race, ethnicity, insurance status, and basic needs adversity. Understanding these complex issues is essential to the development of effective programs and policies to advance health equity and improve public health outcomes.

Selected Publications

  • Contraceptive knowledge, decision-making and acceptability 
  • Contraceptive use and pregnancy outcomes

Contraceptive knowledge, decision-making and acceptability

  1. Harper CC, Rao, L, Muñoz I, Stern L, Kerns JL, Parra M, Chambers BD, Rocca CH. Agency in Contraceptive Decision-Making in Patient Care: a Psychometric Measure. J Gen Intern Med, 2022.
  2. Cabral MA, Schroeder R, Armstrong EM, El Ayadi AM, Gürel AL, Chang J, & Harper CC. Pregnancy intentions, contraceptive knowledge and educational aspirations among community college students. Perspectives on Sexual and Reproductive Health, 2018.
  3. Goodman SR, El Ayadi AM, Rocca CH, Kohn JE, Benedict CE, Dieseldorff JR, Harper CC. The intrauterine device as emergency contraception: how much do young women know? Contraception, 2018.
  4. Jones EA, Schroeder R, Tebb KP, Boyer CB, Harper, CC. Young adult male knowledge of emergency contraception. Journal of Adolescent Health, 62(2), p.S61, 2018. 
  5. 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.
  6. Raine-Bennett TR, Rocca CH. Development of a brief questionnaire to assess contraceptive intent. Patient Education and Counseling 98(11):1425-30, 2015.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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. Steinberg JR, Adler NE, Thompson KM, Westhoff C, Harper CC. Current and past depressive symptoms and contraceptive effectiveness level method selected among women seeking reproductive health services. Soc Sci Med; 214:20-25, 2018. 
  2. 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.
  3. 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.
  4. 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.
  5. Thompson KMJ, Foster Green D, Harper CC. Increased use of intrauterine contraception in California, 1997-2007. Women's Health Issues 21:425-30, 2011.