Assistant Professor Justine Wu, M.D., M.P.H., was recently awarded a NIH K23 Mentored Patient-Oriented Research Career Development Award. Wu is a reproductive health researcher who has authored over 30 publications on contraceptive care and reproductive health training in the family medicine specialization. Over the next five years, the research grant will support Dr. Wu’s targeted research plan as she develops a web-based contraception decision aid for women with medical conditions and their primary care providers.
Addressing one-size-fits-all family planning
Family planning services for women with medical conditions tend to be one-size-fits-all. The goal of Dr. Wu’s research and decision aid will be to invite dialogue and generate dynamic understanding of the contraceptive care needs of women with medical conditions.
According to Dr. Wu, “Instead of walking into a primary care setting, typically, and asking ‘What would you like for birth control? Here’s a list of things,’ the approach will be to back up, to say, ‘Hey, let’s clarify your goals and personal values. What does it mean to you today, six months from now, is it still the same?’ Women’s decision-making and feelings about pregnancy change. Sometimes they’re static for years, but with a change of partner, change in financial status, change in health, they need to be reassessed. Right now, we treat choice like it’s static.”
“That tailoring, to the woman’s needs at that point in time, is what I think is unique about the tool. It’s addressing the spectrum of what family planning services can look like, and it’s really emphasizing it is dynamic and far from static.”
The Research Process
The research project, titled Mi Health Mi Choice, will begin with a mixed methods assessment of patient-, provider-, and practice-level needs and barriers to family planning services for women with medical conditions. The initial assessment will include patients and providers who manage a range of medical experiences, including diabetes, high blood pressure, thyroid issues, heart or lung problems, depression, epilepsy, and severe asthma. The array of conditions reflect prevalent conditions Dr. Wu and other primary care providers encounter in practice settings.
From their needs assessment, Dr. Wu will develop an intervention in the form of a web-based decision aid that will support informed decision-making.
Wu explains that the decision tool will “focus on guiding women through the decision-making process, helping them to clarify their values up-front, making sure their providers know what their values are, and then going from there.”
Dr. Wu has formed her core research team, and they call themselves ReMix, which blends 'Re'productive health research and 'Mix'ed methods. Central to the research team is research project coordinator Susan Taichman. Currently, Dr. Wu and her research team are recruiting patients, providers, and practices to take part in the needs assessment (NCT03153644).
Dr. Wu will be supported by a team of mentors and consulting advisors:
Timothy RB Johnson, M.D. is the Bates Professor of the Diseases of Women and Children and Chair of the Department of Obstetrics and Gynecology at U-M. He is a Maternal Fetal Medicine (MFM) specialist who has mentored many junior faculty members who have achieved independent research careers in women’s health. Based upon his expertise with pregnancy-related complications among women with chronic and complex medical conditions, Dr. Johnson will provide guidance regarding key clinical and counseling issues to consider in the intervention design.
Brian Zikmund-Fisher, Ph.D. is a behavioral scientist and Associate Professor of Health Behavior and Health Education in the U-M School of Public Health and a Research Associate Professor in the UM Department of Internal Medicine. He is an expert in behavioral decision theory. He will provide guidance in the application of decision theory, particularly risk-based communication, in the development of the decision aid.
Dr. Wu will also seek guidance from a group of consulting advisors, including Masahito Jimbo, M.D., Ph.D., M.P.H. Professor of Family Medicine and Urology at the University of Michigan, Michael Klinkman, M.D., M.S., Professor of Family Medicine and Director of the Great Lakes Research into Practice Network (GRIN), and Christine Dehlendorf, M.D., M.A.S., a family physician and Associate Professor in the Department of Family Community Medicine at the University of California, San Francisco. Dr. Wu would like to acknowledge a key mentor in her professional development, who will also serve as an advisor for her K23 research: Mack Ruffin IV, Chair of the Department of Community and Family Medicine at Penn State University. Dr. Ruffin previously served as Associate Chair of Research in the U-M Department of Family Medicine.
Dr. Wu wishes to thank her all-star cast of mentors and advisors as she embarks on the Mi Health Mi Choice project and to express her gratitude for their continued guidance in her training as a research investigator.
Find the pre-print research protocol, "A web-based decision tool to improve contraceptive counseling for women with chronic medical conditions in primary care: Protocol for a mixed methods implementation study." It was submitted to the Journal of Medical Internet Research Research Protocols in late October 2017.
To read a recent publication on Dr. Wu's work on contraceptive choice for women with physical and/or sensory disabilities, see:
Wu JP, McKee KS, McKee MM, Meade MA, Plegue MA, Sen A. Use of Reversible Contraceptive Methods Among U.S. Women with Physical or Sensory Disabilities. Perspect Sex Reprod Health. 2017 May 17 (ePub ahead of print). doi: 10.1363/psrh.12031.
Wu JP, McKee MM, Mckee KS, Mead, MA, Plegue M, Sen A. Female sterilization is more common among women with physical and/or sensory disabilities than women without disabilities in the United States. Disability and Health Journal. 2017 Jan. DOI: 10.1016/j.dhjo.2016.12.020
Browse the latest department research on reproductive and women's health.
[This article was updated November 2, 2017 to include the research protocol paper.]