Autonomy in contraceptive choice and contraceptive satisfaction among women in Seine Seine-SaintSaint-Denis: protocol for ESAACO93study

Introduction: Despite high contraceptive coverage in France, unplanned pregnancies remain common. Contraceptive satisfaction and autonomy in contraceptive choice influence adherence to contraceptive methods, but their direct association remains underexplored. Seine-Saint-Denis, a department characterized by substantial social inequalities in health and contraceptive coverage below the national average, provides a particularly relevant setting in which to explore this issue. Aim: To investigate the association between contraceptive satisfaction and autonomy in contraceptive choice among women living in Seine-Saint-Denis. Method: This quantitative cross-sectional study includes women aged 18 to 54 years who use contraception. Data are collected in various public spaces in Seine-Saint-Denis to limit recruitment from healthcare settings. Contraceptive satisfaction is assessed using the validated Treatment Satisfaction with Medicines Questionnaire (SATMED-Q), and autonomy in contraceptive choice using the Family Planning Autonomous Decision-Making scale (FP-ADM). The sociodemographic characteristics and contraceptive methods are also recorded. Descriptive, bivariate, and multivariable analyses are performed to investigate associations between contraceptive satisfaction, autonomy in contraceptive choice, and variables of interest. Discussion: To our knowledge, this study is the first to explore the association between contraceptive satisfaction and autonomy in contraceptive choice in the French context. It could contribute to a better understanding of the determinants of contraceptive experience in primary care and highlight the value of a person-centered approach in contraceptive consultations. The findings could also guide the development of healthcare professional decision-making tools tailored to populations most affected by social inequalities in health.