Adolescents’ attitudes about long-acting reversible contraception: Exploring a youth-centered counseling approach
Hoopes, Andrea Jeanne
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Background: 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 LARC with their teen patients, but little is known about how to introduce these methods in the pediatric primary care setting. The purpose of this study was to explore attitudes and experiences related to pregnancy and contraception in a diverse population of female adolescents to inform the development of LARC counseling strategies relevant to a wide range of primary care patients. Methods: Qualitative interviews were conducted with female adolescent patients at two urban school-based health centers. Questions elicited information about participants’ family, school, peers, and extracurricular activities, reproductive life plan, and experiences with contraception and school health services. Interviews were audio recorded, transcribed, and coded using a combination of inductive and deductive coding to identify major themes. Results: A total of 30 women (mean age 16.2 years, range 14 to 18 years) participated in interviews representing a diverse range of racial/ethnic identities. Half of the participants were sexually active, and 17% reported current or past LARC use. We identified four thematic code-families related to LARC attitudes among our participants, including (1) device-specific characteristics of IUDs and implants that are appealing or unappealing to adolescents, (2) prior exposure to information about LARC either from peers, family members, or health counseling sessions, (3) salient circumstances or experiences that may motivate a desire for effective and/or long-acting contraception, and (4) environments and social norms that influence LARC acceptability among adolescents. Conclusions: This study informed the development of an adolescent-centered LARC counseling tool that can be used to elicit and address the unique factors that shape adolescent attitudes about LARC devices and facilitate patient-provider discussions. Further study is warranted to evaluate the effect of this tool on provider comfort with LARC counseling and acceptability and knowledge of LARC among adolescents and their families.
- Health services