Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Public Health England, Wellington House, Waterloo Road, London, SE1 8UG, UK.
BMC Public Health. 2021 Nov 27;21(1):2176. doi: 10.1186/s12889-021-12212-7.
Many pregnancies in the UK are either unplanned or ambivalent. This review aimed to (i) explore barriers and facilitators to women choosing and accessing a preferred method of contraception in the United Kingdom, and (ii) identify opportunities for behavioural interventions based on examination of interventions that are currently available nationally.
Three databases were searched, and experts contacted to identify grey literature for studies presenting barriers and facilitators to women choosing and accessing a preferred method of contraception, conducted in the UK and published between 2009 and October 2019. Information on barriers and facilitators were coded into overarching themes, which were then coded into Mechanisms of Actions (MoAs) as listed in the Theory and Techniques Tool. National interventions were identified by consulting stakeholders and coded into the Behaviour Change Wheel. The match between barriers/facilitators and intervention content was assessed using the Behaviour Change Wheel.
We included 32 studies and identified 46 barrier and facilitator themes. The most cited MoA was Environmental Context and Resources, which primarily related to the services women had access to and care they received. Social Influences, Beliefs about Consequences (e.g., side effects) and Knowledge were also key. The behavioural analysis highlighted four priority intervention functions (Modelling, Enablement, Education and Environmental Restructuring) that can be targeted to support women to choose and access their preferred method of contraception. Relevant policy categories and behaviour change techniques are also highlighted.
This review highlights factors that influence women's choices and access to contraception and recommends opportunities that may be targeted for future interventions in order to support women to access preferred contraception.
Protocol was registered with PROSPERO (an international database of prospectively registered systematic reviews in health and social care) in December 2019, CRD42019161156 .
在英国，许多妊娠不是计划内的，或者是矛盾的。本综述旨在：（i）探讨英国女性选择和获得首选避孕方法的障碍和促进因素；（ii）基于对当前全国范围内可用的干预措施的检查，确定行为干预的机会。
搜索了三个数据库，并联系专家以确定在英国进行的、发表于 2009 年至 2019 年 10 月期间的研究报告，这些研究报告介绍了女性选择和获得首选避孕方法的障碍和促进因素的灰色文献。将障碍和促进因素信息编码为总体主题，然后根据理论和技术工具中列出的作用机制（MoAs）进行编码。通过咨询利益相关者确定国家干预措施，并将其编码到行为改变轮中。使用行为改变轮评估障碍/促进因素与干预内容之间的匹配情况。
我们纳入了 32 项研究，确定了 46 个障碍和促进因素主题。被引用最多的 MoA 是环境背景和资源，主要与女性可获得的服务和接受的护理有关。社会影响、对后果的信念（如副作用）和知识也是关键。行为分析突出了四个优先干预功能（示范、赋能、教育和环境重构），这些功能可以针对这些功能进行干预，以支持女性选择和获得她们首选的避孕方法。还突出了相关的政策类别和行为改变技术。
本综述强调了影响女性选择和获得避孕方法的因素，并建议了未来干预的可能目标，以支持女性获得首选避孕方法。
该方案于 2019 年 12 月在 PROSPERO（一个健康和社会保健领域前瞻性注册系统评价的国际数据库）中进行了注册，CRD42019161156。
