# Development and Testing of a Point-of-Care Shared Decision-Making Tool for Providers

> **NIH NIH K23** · UNIVERSITY OF MARYLAND BALTIMORE · 2020 · $163,165

## Abstract

Title: Improving Contraceptive Counseling for Immigrant Latinas: Development and Testing of a Point-of-
Care Shared Decision-Making Tool for Providers
The PI, Diana N. Carvajal, MD MPH, is an Assistant Professor of Family Medicine at the University of 
Maryland School of Medicine with a clinical and research focus on improving family planning outcomes for 
vulnerable populations. Her long-term goal is to be an independent researcher and leader in women’s reproductive
health, focused on decreasing rates of unintended pregnancy and associated adverse outcomes for vulnerable
populations. To that end, the proposed project will develop and test an ethnically-responsive contraceptive
counseling tool to improve healthcare providers’ shared decision-making (SDM) skills with Latina immigrants.
Many contextual factors including immigration experiences, language barriers, access to care, and partner 
involvement, can influence the contraceptive decision-making and use of Latina immigrants. My recent work in
Baltimore, MD has also found that Latina immigrants perceive poor communication with providers about 
contraceptive priorities as negatively affecting their decision-making. Patient-provider communication impacts
contraceptive use and adherence, and the provision of patient-centered communication during contraceptive
counseling is consistent with an SDM approach. SDM provides a model to support patient decisions in a way
that is informed by and responds to important patient-identified contextual factors. Few support tools focus on
improving providers’ SDM skills during contraceptive counseling, and none are ethnically-responsive to Latina
immigrants. Therefore, I propose to build upon established relationships with the immigrant Latino 
community and with providers in Baltimore to achieve three specific aims with help from my mentors who are experts in
family planning, patient-provider communication, and intervention development and evaluation. I will: 1)
conduct a qualitative study of providers to elicit their perspectives about: a) current counseling practices; b)
barriers to use of SDM; c) immigrant Latinas’ contraceptive preferences and factors for these; and d) the design
of an SDM POC tool; 2) measure provider use and patient experience of SDM during counseling visits and
patient outcomes; 3) develop and test the usability and acceptability of a provider-targeted POC tool to
facilitate SDM with Latina Immigrants.
With specific expertise and guidance from my mentors and advisors, I propose a career development plan to
achieve: 1) expansion of my qualitative research skills (Drs. Zambrana and DeForge); 2) expertise in SDM and
its measurement (Drs. Barnet, Duggan, and Dehlendorf); 3) skills in the development and testing of clinical
tools; and 4) skills in advanced research techniques to establish psychometric properties of instruments (Drs.
Barnet and Duggan). This training award will prepare me to submit an R01 to test the tool’s effectiveness in a
...

## Key facts

- **NIH application ID:** 9985114
- **Project number:** 5K23HD096056-02
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** DIANA N CARVAJAL
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $163,165
- **Award type:** 5
- **Project period:** 2019-07-29 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985114

## Citation

> US National Institutes of Health, RePORTER application 9985114, Development and Testing of a Point-of-Care Shared Decision-Making Tool for Providers (5K23HD096056-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9985114. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*