Male patients are being left out of the family planning discussion. Patient gender (female) and provider specialization (family medicine) may be associated with higher rates of family planning discussion. While socioeconomic status and income of patient population may not be associated with provider-related factors related to family planning and vasectomy discussion, the prevalence of minorities in a patient population may play a role. Providers may not be aware of the family planning resources available to their patients, such as Rhode Island’s No Cost Vasectomy Program. To investigate why we observe disparities in vasectomy utilization, an integrated look at both patient and provider-sided factors— including attitudes, misconceptions, and awareness of resources—is warranted. Ezekiel E. Young a, Brian T. Nguyen b, Nomi S. Weiss-Laxer c, Mark Sigman d, Patricia A. Nolan e a Dept of Urology, University of Miami Miller School of Medicine; b Alpert Medical School at Brown University; c School of Nursing and Health Studies, University of Miami; d Division of Urology, Alpert Medical School at Brown University; e Department of Community Health, Alpert Medical School at Brown University Sterilization through vasectomy is (1) less expensive, (2) less invasive and (3) safer than female sterilization through tubal ligation. 1,2 Tubal ligation is utilized ~3x as often, contributing to an overall underutilization of vasectomy in the U.S. 3 Underutilization may be due to patient concerns or misconceptions about vasectomy, 4 poor access to family planning services and male underutilization of health care in general. 5,6 Minorities are less likely to utilize vasectomy than other groups. 7 Increased uptake may depend on the ability and willingness of providers to reorient men towards positive aspects of vasectomy and help patients overcome fears and misconceptions. 8,9 It may also depend on the providers’ ability to link patients to programs providing free or low-cost vasectomy options. Provider Knowledge Almost all (>90%) of providers endorsed the benefits of vasectomy over tubal ligation – safer, less expensive, less invasive. Provider Attitudes More US providers believed vasectomy is underutilized (83.9%) compared to tubal ligation (23.9%) Provider Sterilization Discussion & Recommendation Providers discussed both family planning and vasectomy more with female pts than with male pts, (p=0.001 & p= respectively) Among female pts, there was an assoc. between frequent discussion of vasectomy & tubal ligation(p<0.001) 18% of providers were aware of Rhode Island’s No Cost Vasectomy Program and 7.5% referred pts in the past year. Purpose: To understand provider-related factors related to the utilization of vasectomy. Key questions: 1. Are providers addressing family planning and sterilization options with their patients? 2. Do these discussions target female and male patients equally? 3. Are there specific provider-related factors associated with whether or not these discussions are taking place? 4. Are providers aware of local resources available for underinsured men, such as Rhode Island’s No Cost Vasectomy Program? Providence Blue Cross Blue Shield - ‘Doctor Finder’ One-time anonymous mailed survey to primary care health providers in Internal Medicine, OB/GYN, & Family Medicine 224 surveys mailed, 67 completed => RR = 30% 1. Hendrix NW, Chauhan SP, and Morrison JC. Sterilization and its consequences. Obstetrical and Gynecological Survey. 1999, 54(12): Kjersgaard AG et al. Male or female sterilization: a comparative study. Fertility & Sterility. 1989, 51(3): Bensyl, DM, Iuliano D, Carter M, Santelli J, Gilbert BC. Contraceptive use—United States and territories, behavioral risk factor surveillance system. Morbidity and Mortality Weekly Report Nov, 54(SS06): 1– Bressler J, Landry E, Ward V. Choosing Vasectomy: U.S. Clients Discuss Their Decisions. Avsc News Fall, 34 (3). 5. Finger WR. Attracting men to vasectomy. Network, 1998 Spring, 18(3): Bertakis KD, Azari R, Helms J, Callahan EJ, Robbins JA. Gender Differences in the Utilization of Health Care Services. Journal of Family Practice Vol. 49: September 20, Barone MA et al. Vasectomy in the United States, The Journal of Urology. 2006, 176(1): Balde A, Legare F, Labrecque M. Assessment of needs of men for decision support on male sterilization. Pat Educ and Counseling Nov, 63(3). 9. Spencer BE. How men come to hear about vasectomy: evidence from a Manchester clinic in the UK. International J. of Health Education. 1978, 1(2). Factors Associated with Family Planning & Vasectomy Discussion: Results from a Health Provider Survey INTRODUCTIONSTUDY AIMS & PURPOSEMETHODS & DEMOGRAPHICS RESULTS FAMILY PLANNING DISCUSSION REFERENCES CONCLUSIONS VASECTOMY DISCUSSION Providers w/ more male pts were less likely to discuss family planning (p=0.014) with female pts compared to those w/more female pts. In pt populations of >25% minorities, providers were more likely to discuss family planning (p<0.001) with female patients. In pt populations of >25% Medicaid- eligible pts, providers were more likely to discuss family planning with female patients (p=0.002). Providers with more male patients were less likely to discuss vasectomy (p=0.041) with female patients compared to providers with more female patients. In pt populations of >25% minorities, providers were more likely to discuss vasectomy (p=0.015) with female patients. Female providers were more likely to talk about vasectomy with female pts than male pts (p=0.018).