University of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, 5841 S. Maryland Ave. - MC2050, Chicago, IL 60637..
Contraception. 2019 Apr;99(4):228-232. doi: 10.1016/j.contraception.2019.01.002. Epub 2019 Jan 24.
We explored how negative stories about long-acting reversible contraception (LARC) - defined as a firsthand negative experience with LARC shared directly with the study participant - were involved in participants' decisions about whether to use LARC following abortion, and how counseling affected the influence of negative LARC stories on contraceptive choices.
We performed a multi-methods study, embedded within a trial examining the impact of a theory-based counseling intervention on LARC uptake post-abortion. Participants completed a baseline survey to determine the influence of negative LARC stories. We subsequently invited respondents who reported having heard negative LARC stories to participate in a semi-structured qualitative interview. We analyzed quantitative data with univariate statistics. We analyzed qualitative data using thematic content analysis.
Among the 60 participants, 16 (27%) reported having heard negative LARC stories. Two of the 16 (13%) planned to initiate LARC prior to counseling, compared to 18 of 44 women (41%) who had not heard negative LARC stories (p=0.06). Prior to counseling, 69% of participants with negative LARC stories reported that these stories made them less likely to use LARC. In qualitative interviews with 9 women, we identified several key themes: (1) negative LARC stories deterred LARC use; (2) friends and family were valued informants; (3) potential side effects were important to LARC decision-making; and (4) positive and negative features of the counseling encounter influenced the effect of negative LARC stories.
Negative LARC stories are common among women presenting for abortion at our institution and may influence patient uptake of these methods. Implications This study uses a multi-methods approach to examine the influence of negative stories about long-acting reversible contraception (LARC) on decision-making about LARC. These findings can help providers elicit patients' needs in contraception counseling and generate hypotheses for future counseling research.
本研究旨在探讨关于长效可逆避孕（LARC）的负面故事（定义为直接与研究参与者分享的关于 LARC 的第一手负面经历）如何影响参与者在堕胎后使用 LARC 的决定，以及咨询如何影响负面 LARC 故事对避孕选择的影响。
我们进行了一项多方法研究，嵌入在一项评估基于理论的咨询干预对堕胎后 LARC 使用率影响的试验中。参与者完成了基线调查，以确定负面 LARC 故事的影响。随后，我们邀请了报告听到负面 LARC 故事的受访者参加半结构化定性访谈。我们使用单变量统计分析对定量数据进行分析。我们使用主题内容分析对定性数据进行分析。
在 60 名参与者中，16 名（27%）报告听到过负面 LARC 故事。在接受咨询之前，有 2 名（13%）计划开始使用 LARC，而没有听到过负面 LARC 故事的 44 名女性中有 18 名（41%）（p=0.06）。在接受咨询之前，有负面 LARC 故事的参与者中有 69%表示这些故事使他们不太可能使用 LARC。在对 9 名女性进行的定性访谈中，我们确定了几个关键主题：（1）负面 LARC 故事阻止了 LARC 的使用；（2）朋友和家人是有价值的信息来源；（3）潜在的副作用对 LARC 决策很重要；（4）咨询过程中的正面和负面特征影响了负面 LARC 故事的影响。
在我们机构接受堕胎的女性中，负面 LARC 故事很常见，可能会影响这些方法的患者使用率。本研究使用多方法方法来检查关于长效可逆避孕（LARC）的负面故事对 LARC 决策的影响。这些发现可以帮助提供者在避孕咨询中了解患者的需求，并为未来的咨询研究提出假设。
