Factors Determining the Implementation of Shared Decision-Making Principles in Family Planning Counseling: A Scoping Review

Shared decision-making (SDM) is a collaborative approach to healthcare that integrates patient preferences with health care provider expertise to improve the quality of decisions. In family planning, SDM is critical to tailoring contraceptive methods to individual needs. This scoping review, conducted in accordance with the PRISMA-ScR guidelines, examined factors influencing SDM implementation. A literature search in PubMed, ProQuest, Cochrane CENTRAL, and ScienceDirect databases identified ten eligible studies focused on reproductive age and health care providers. Results showed that influencing factors fell into three categories: related to health care providers (communication, empathy, decision aids), patient-related (preferences, lifestyle, insurance), and environmental (stigma, cultural norms, logistical barriers). Effective communication and trust were essential for the successful implementation of SDM, while stigma and systemic constraints were significant barriers, particularly in resource-limited settings. This review identifies multilevel factors influencing the implementation of a SDM model in family planning counseling and integrates them into a holistic framework, thereby providing a novel basis for developing and evaluating interventions to strengthen patient-centered decision-making regarding contraception.