My Decision

Principle Investigator

Sonya Borrero, MD, MS, University of Pittsburgh School of Medicine and VA Pittsburgh Healthcare System

Funding

  • National Institutes of Health (R01 MD011678)

My Decision/Mi Decisión Explained

There is growing evidence that the current Medicaid policy surrounding tubal sterilization does not support patient comprehension, thereby impeding one’s ability to make an informed decision.

My Decision/Mi Decisión is a patient-centered, web-based decision aid to facilitate informed and value-concordant decision-making among Medicaid enrollees considering tubal sterilization for permanent contraception. It was developed through a stakeholder-engaged process including a needs assessment, diverse Steering Committee, cognitive interviews, and beta testing (read more about the process here).

We did a needs assessment with 40 women on lower incomes (who had considered tubal sterilization) and 15 OBGYNs. Results from the interviews helped inform development of My Decision/Mi Decisión. Findings from the interviews with OBGYNs were published in Contraception (needs assessment).

Primary outcomes have been completed. The decision aid significantly increased knowledge about tubal sterilization and significantly decreased decisional conflict. Longitudinal data collection for secondary and exploratory outcomes is ongoing. Anticipated end date for data collection is mid-December of 2023.

More Information 

There are 4 main components of the decision aid:

  1. Get the Facts: Users are presented with information about pregnancy and tubal sterilization in the form of videos, text summaries, and knowledge check questions. Common misconceptions about permanence, effectiveness, and difficulty of reversal are also addressed in this section. 
  2. Know Your Options: Users are provided with tailored feedback on their postpartum decision, as well as an interactive portion that allows them to compare all methods of contraception based on a range of factors.
  3. Take Time to Reflect: This section gives users the space to reflect on their decision by asking guiding questions.

  4. Your Decision: Users still facing uncertainty are provided with additional counseling, and a summary report is provided to all users in case they want to share their responses with their provider.

 

Contact

Call or Text Dr. Elizabeth Mosley at 470-219-8153 or email MyDecisionStudy@pitt.edu for more information.