Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Section of Adolescent Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
J Adolesc Health. 2017 Oct;61(4):454-460. doi: 10.1016/j.jadohealth.2017.04.008. Epub 2017 Jul 14.
The purpose of the study was to identify factors associated with uptake of contraceptive implants or intrauterine devices (IUDs) by adolescents and young women.
For this prospective cohort study, we recruited English-speaking female contraceptive initiators aged 14-24 years attending a Title X-supported, youth-focused clinic. Immediately prior to their visits, participants completed surveys assessing demographic and reproductive characteristics and awareness of, interest in, and intent to initiate specific contraceptive methods. Participants also answered questions about their social contacts' contraceptive experiences. Following the visit, participants reported the method initiated and the perceived importance of provider counseling. We used a multivariable regression model to ascertain factors associated with initiation of an IUD, an implant, or a short-acting reversible method.
We enrolled 1,048 contraceptive initiators: 277 initiated short-acting methods, 384 IUDs, and 387 implants. High previsit personal acceptability of the method was associated with choosing that method for both implants and IUDs. Knowing someone who uses a specific method and likes it was predictive of personal acceptability of that method (IUD adjusted odds ratio: 10.9, 95% confidence interval: 3.8-31.1; implant adjusted odds ratio: 7.0, 95% confidence interval: 2.3-21.0). However, 10.4% of those initiating IUDs and 14.2% of those initiating implants had never heard of the method before their appointment. Even women with previsit intent to initiate a specific method found importance in contraceptive counseling.
Previsit personal acceptability, which was associated with social contacts' experiences, was the strongest predictor of specific method uptake in our study. However, counseling informed the decisions of those with low previsit awareness and supported patients with formed intent.
本研究旨在确定与青少年和年轻女性采用避孕植入物或宫内节育器（IUD）相关的因素。
本前瞻性队列研究招募了在一家接受 Title X 资助的、以年轻人为重点的诊所就诊的 14-24 岁的讲英语的女性避孕初使用者。在就诊前，参与者完成了调查，评估了人口统计学和生殖特征以及对特定避孕方法的认识、兴趣和意图。参与者还回答了关于其社交联系人避孕经历的问题。就诊后，参与者报告了开始使用的方法以及对提供者咨询的重视程度。我们使用多变量回归模型确定与 IUD、植入物或短效可逆方法的起始相关的因素。
我们共招募了 1048 名避孕初使用者：277 人开始使用短效方法，384 人使用 IUD，387 人使用植入物。就诊前对方法的高度个人接受度与选择该方法植入物和 IUD 相关。了解使用特定方法且喜欢该方法的人，与个人对该方法的接受度相关（IUD 调整后的优势比：10.9，95%置信区间：3.8-31.1；植入物调整后的优势比：7.0，95%置信区间：2.3-21.0）。然而，10.4%开始使用 IUD 的人和 14.2%开始使用植入物的人在就诊前从未听说过该方法。即使是那些在就诊前有意图开始使用特定方法的女性，也认为避孕咨询很重要。
在我们的研究中，就诊前的个人接受度与社交联系人的经验相关，是特定方法采用的最强预测因素。然而，咨询为那些就诊前认识度低的人做出决策提供了信息，并支持了有既定意向的患者。
