Fear of intrauterine contraception among adolescents in New York City

Potter, Julia M.; Rubin, Susan E.; Sherman, Peter

doi:10.1016/j.contraception.2014.01.011

Cited by 92 publications

(58 citation statements)

References 18 publications

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“…IUC aspects cited as of value to our participants-- “low maintenance”, high efficacy, longevity, and possibility for device removal prior to expiration, are similar to those reported in studies of adolescent and young women’s perceptions of and theoretical interest in IUC 14–16 as well as a study of actual users. 18 Our finding that respondents consider their HCP to be an important source of contraception information and influential during the IUC decision-making process is also consistent with the literature.…”

Section: Discussionsupporting

confidence: 69%

“…Several studies have examined adolescents’ knowledge, beliefs, and interest in IUC from the perspective of non -IUC users. 14–17 There is limited data about the experiences of adolescents or young women who actually use IUC. In a qualitative study out of St Louis, adolescents and young women who were relatively new IUC users reported that they chose IUC because of the device’s effectiveness, potential long duration of use and convenience.…”

Section: Introductionmentioning

confidence: 99%

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Urban Adolescents' and Young Adults' Decision-Making Process around Selection of Intrauterine Contraception

Rubin

Felsher

Korich

et al. 2016

Journal of Pediatric and Adolescent Gynecology

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Study Objective To examine adolescent and young adults’ priorities, values and preferences affecting the choice to use intrauterine contraception (IUC). Design and participants Qualitative exploratory semi-structured interviews with 27 females 16–25 years old on the day of their IUC insertion. Analysis was done using a modified grounded theory approach. Setting Outpatient adolescent medicine clinic located within an academic children’s hospital in the Bronx, New York Results We identified four broad factors affecting choice: (1) personal, (2) IUC device-specific, (3) health care provider (HCP), and (4) social network. The majority of the participants perceived an ease with a user-independent method and were attracted by the IUC’s high efficacy, potential longevity of use and the option to remove the device prior to its’ expiration. Participants described their HCP as being the most influential individual during the IUC decision-process via provision of reliable, accurate contraceptive information and demonstration of an actual device. Of all people in their social network, mothers played the biggest role. Conclusions Adolescents and young women choosing IUC appear to value IUCs’ efficacy and convenience, their relationship with and elements of clinicians’ contraceptive counseling, and their mother’s support. Our results suggest that during IUC counseling, clinicians should discuss these device-specific benefits, elicit patient questions and concerns, and use visual aids including the device itself. Incorporating the factors we found most salient into routine IUC counseling may increase the number of adolescents and young women who choose IUC as a good fit for them.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Urban Adolescents' and Young Adults' Decision-Making Process around Selection of Intrauterine Contraception

Rubin

Felsher

Korich

et al. 2016

Journal of Pediatric and Adolescent Gynecology

Self Cite

View full text Add to dashboard Cite

show abstract

“…5,6 Barriers to IUD utilization including lack of knowledge, negative personal attitudes, negative social norms, and limited IUD access, particularly in pediatric care settings. 7–9 Interventions have focused on improving access, promoting patient-centered counseling, and promoting long-acting methods. 10,11 …”

Section: Introductionmentioning

confidence: 99%

“…Improving our understanding of young women’s experiences during the procedure may aid with counseling and service delivery, help address pre-procedure anxiety, identify modifiable aspects of the procedure, and improve IUD uptake. 7–9,12 Studies assessing young women’s satisfaction with the IUD measure satisfaction six to 12 months after device placement; we are not aware of any studies assessing young women’s satisfaction immediately following IUD insertion. 13–15 In the current study, we examine satisfaction with the IUD insertion procedure and predictors of satisfaction among adolescent and young adult women participating in a randomized clinical trial that examined the effectiveness of a 1% lidocaine paracervical nerve block on pain reported during IUD insertion compared to a sham block.…”

Section: Introductionmentioning

confidence: 99%

Satisfaction With the Intrauterine Device Insertion Procedure Among Adolescent and Young Adult Women

Akers

Harding

Perriera

et al. 2018

Obstetrics &Amp; Gynecology

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OBJECTIVE To evaluate satisfaction with intrauterine device (IUD) insertion procedures among adolescent and young adult women. METHODS This secondary analysis of data from a multisite, single-blind, sham-controlled randomized trial of women having a levonorgestrel 13.5 mg IUD inserted enrolled participants from March 2015 through July 2016 at 3 family planning clinics in Philadelphia, Pennsylvania. Eligible women were 14 to 22 years, nulliparous, not pregnant, and English speaking. Randomization was via computer generated allocation in block sizes of 4 to a 1% lidocaine paracervical or sham block. Only patients were blinded. Satisfaction was measured with 3-items that assessed overall satisfaction with the procedure, whether participants would recommend the IUD to friend, and the perception that the IUD was worth the discomfort. Predictors included demographics, sexual and reproductive history, pain following IUD insertion, and treatment group. RESULTS Ninety-five women enrolled; 93 (97.9%) were included in the analysis. Forty-five (47.4%) were white, 34 (36.0%) were black, 62 (66.0%) privately insured, and 75 (79.0%) previously used contraception. Most (n=71, 76.8%) reported high overall satisfaction with the procedure, 62 (67.4%) would recommend an IUD to a friend, and 77 (83.2%) perceived the IUD was worth the discomfort. The odds of reporting high overall satisfaction were lower among adolescents compared to young adults (OR 0.07, 95% CI: 0.008, 0.68); those who never had a gynecologic exam compared to those who had (OR 0.26; 95% CI: 0.069, 0.99); and decreased as pain score increased (OR 0.96; 95% CI: 0.94, 0.99). Higher pain scores were negatively correlated with the odds of recommending an IUD to a friend and perceiving the IUD was worth the discomfort. CONCLUSION Adolescent and young adult women report high levels of satisfaction following the IUD insertion procedure. Young age, lack of experience with gynecologic exams, and high pain were inversely related to satisfaction. Clinical Trial Registration ClinicalTrials.gov, https://clinicaltrials.gov, NCT02352714.

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“…The few studies that have examined LARC experiences of adolescents in a primary care setting note substantial patient and provider-level barriers to LARC acceptability and uptake. 7,8 …”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Factors That Influence Contraceptive Choice among Adolescent School-Based Health Center Patients

Hoopes

Gilmore

Cady

et al. 2016

Journal of Pediatric and Adolescent Gynecology

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Study Objective Long-acting reversible contraceptive (LARC) methods can prevent teen pregnancy yet remain underutilized by adolescents in the United States. Pediatric providers are well positioned to discuss LARCs with adolescents, but little is known about how counseling should occur in pediatric primary care settings. We explored adolescent womens’ attitudes and experiences with LARCs to inform the development of adolescent-centered LARC counseling strategies. Design Qualitative analysis of one-on-one interviews. Setting Participants were recruited from 2 urban school-based, primary care centers. Participants Thirty adolescent women aged 14–18 years, diverse in race/ethnicity, and sexual experience. Interventions Interviews were audio-recorded, transcribed, and coded using inductive and deductive coding. Main Outcome Measure Major themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches. Results Participants (mean age, 16.2 years; range, 14–18 years) represented a diverse range of racial and/or ethnic identities. Half (15/30) were sexually active and 17% (5/30) reported current or past LARC use. Five themes emerged regarding key factors that influence LARC choice, including: (1) strong preferences about device-specific characteristics; (2) previous exposure to information about LARCs from peers, family members, or health counseling sessions; (3) knowledge gaps about LARC methods that affect informed decision-making; (4) personal circumstances or experiences that motivate a desire for effective and/or long-acting contraception; and (5) environmental constraints and supports that might influence adolescent access to LARCs. Conclusion We identified 5 factors that influence LARC choice among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings.

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Fear of intrauterine contraception among adolescents in New York City

Cited by 92 publications

References 18 publications

Urban Adolescents' and Young Adults' Decision-Making Process around Selection of Intrauterine Contraception

Urban Adolescents' and Young Adults' Decision-Making Process around Selection of Intrauterine Contraception

Satisfaction With the Intrauterine Device Insertion Procedure Among Adolescent and Young Adult Women

A Qualitative Study of Factors That Influence Contraceptive Choice among Adolescent School-Based Health Center Patients

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