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Brandão JDP, Machado RB, Cardoso ACF. Knowledge, Use, and Perception of Brazilian Women about Contraceptive Methods: An Observational Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:460-472. [PMID: 39035133 PMCID: PMC11257120 DOI: 10.1089/whr.2023.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 07/23/2024]
Abstract
Background In Brazil, where approximately 48.7 million women are of reproductive age, understanding contraceptive practices is essential for addressing public health challenges. This study evaluated into the knowledge, usage, and perceptions of contraceptive methods among Brazilian women, highlighting the influence of socioeconomic and demographic factors on their choices. Methods We conducted a cross-sectional survey with a representative sample of 2000 Brazilian women aged 18-49 years. The questionnaire collected detailed information on their awareness, preferences, and utilization of various contraceptive methods, alongside demographic and socioeconomic data. Results Oral contraceptives, condoms, injectables, and intrauterine devices (IUDs) were the most recognized methods. Younger women demonstrated greater awareness of modern methods. Socioeconomic disparities were evident, with lower-income women displaying limited knowledge about condoms and IUDs but a higher usage for injectable contraceptives. Oral contraceptives were the most used method, with higher use in the South, and lower in the Central-West and Northeast regions. Satisfaction with current contraceptive methods was high (87.5%), closely associated with personal responsibility in method choice. Although the majority self-financed their contraceptives (63.1%), a significant portion of lower-income women (27.7%) relied on public health care. Physicians' recommendations predominantly influenced contraceptive choice (53.9%), with younger women also guided by other influences. Conclusions Persistent disparities in contraceptive awareness and access highlight the need for educational initiatives and policy interventions. Health care providers play a vital role in facilitating informed contraceptive choices, enhancing the chances of satisfaction with the method.
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Gero A, Elliott S, Baayd J, Cohen S, Simmons RG, Gawron LM. Factors associated with a negative Patient Acceptable Symptom State (PASS) response with intrauterine device placement: A retrospective survey of HER Salt Lake participants. Contraception 2024; 133:110385. [PMID: 38307487 DOI: 10.1016/j.contraception.2024.110385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVES In an established cohort of HER Salt Lake Contraceptive Initiative participants with a prior intrauterine device (IUD) placement, we sought to (1) define the proportion of participants who reported a negative Patient Acceptable Symptom State (PASS) response, (2) explore factors associated with an unacceptable PASS response, and (3) identify pain management preferences for IUD placement. STUDY DESIGN A retrospective survey was sent to 1440 HER Salt Lake IUD users. A PASS question queried IUD placement pain experience acceptability. We explored associations between an unacceptable PASS response and sociodemographic, reproductive and other individual characteristics using t-tests, chi-square tests, and multivariable logistic regression. RESULTS Of those surveyed, 620 responded (43%), and 41.6% reported an unacceptable PASS response. Those with an unacceptable PASS response reported a significantly higher experienced pain level (79.2 mm vs 51.8 mm; p < 0.01) than those with an acceptable response, were more likely to have an anxiety diagnosis (47.7% vs 37.1%; p < 0.01), and have a trauma history (33.7% vs 25.1%; p = 0.02). Most patients were not offered pain control options, but 29.4% used ibuprofen and 25.3% had a support person. Regardless of PASS response, if offered, 59.0% desired numbing medication, 56.8% ibuprofen, 51% heating pad, 33.2% support person, and 31.8% anti-anxiety medication, among others. In our multivariable logistic regression model, higher pain was associated with unacceptable PASS response (OR 1.07, 95% CI 1.05-1.08; p < 0.01). CONCLUSIONS The common finding of unacceptable pain experiences with IUD placement may cause negative perceptions of an otherwise desirable method. Incorporation of the PASS response into IUD pain management studies could expand our pain experience understanding. IMPLICATIONS IUD placement resulted in unacceptable pain experiences for 41.6% of respondents. Screening for anxiety and trauma history could identify at-risk patients to individualize pain management strategies. Incorporation of the PASS into future IUD pain management studies could result in a more comprehensive, patient-centered measure of patient experiences.
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Affiliation(s)
- Alexandra Gero
- ASCENT Center for Reproductive Health, Family Planning Division, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Sarah Elliott
- ASCENT Center for Reproductive Health, Family Planning Division, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Jami Baayd
- ASCENT Center for Reproductive Health, Family Planning Division, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Susanna Cohen
- ASCENT Center for Reproductive Health, Family Planning Division, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Rebecca G Simmons
- ASCENT Center for Reproductive Health, Family Planning Division, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Lori M Gawron
- ASCENT Center for Reproductive Health, Family Planning Division, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, United States.
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Huang M, Gutiérrez-Sacristán A, Janiak E, Young K, Starosta A, Blanton K, Azhir A, Goldfarb CN, Kuperwasser F, Schaefer KM, Stoddard RE, Vatsa R, Merz-Herrala AA, Bartz D. Contraceptive content shared on social media: an analysis of Twitter. Contracept Reprod Med 2024; 9:5. [PMID: 38321582 PMCID: PMC10848475 DOI: 10.1186/s40834-024-00262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/13/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Information on social media may affect peoples' contraceptive decision making. We performed an exploratory analysis of contraceptive content on Twitter (recently renamed X), a popular social media platform. METHODS We selected a random subset of 1% of publicly available, English-language tweets related to reversible, prescription contraceptive methods posted between January 2014 and December 2019. We oversampled tweets for the contraceptive patch to ensure at least 200 tweets per method. To create the codebook, we identified common themes specific to tweet content topics, tweet sources, and tweets soliciting information or providing advice. All posts were coded by two team members, and differences were adjudicated by a third reviewer. Descriptive analyses were reported with accompanying qualitative findings. RESULTS During the study period, 457,369 tweets about reversible contraceptive methods were published, with a random sample of 4,434 tweets used for final analysis. Tweets most frequently discussed contraceptive method decision-making (26.7%) and side effects (20.5%), particularly for long-acting reversible contraceptive methods and the depot medroxyprogesterone acetate shot. Tweets about logistics of use or adherence were common for short-acting reversible contraceptives. Tweets were frequently posted by contraceptive consumers (50.6%). A small proportion of tweets explicitly requested information (6.2%) or provided advice (4.2%). CONCLUSIONS Clinicians should be aware that individuals are exposed to information through Twitter that may affect contraceptive perceptions and decision making, particularly regarding long-acting reversible contraceptives. Social media is a valuable source for studying contraceptive beliefs missing in traditional health research and may be used by professionals to disseminate accurate contraceptive information.
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Affiliation(s)
- Melody Huang
- Harvard Medical School, 25 Shattuck Street, 02115, Boston, MA, USA
| | - Alba Gutiérrez-Sacristán
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Suite 514, 02115, Boston, MA, USA
| | - Elizabeth Janiak
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street CWN-3, 02115, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, 677 Huntington Ave, 02115, Boston, MA, USA
| | - Katherine Young
- Harvard-MIT Program in Health Sciences and Technology, Harvard Medical School, 77 Massachusetts Ave, 02139, Cambridge, MA, USA
| | - Anabel Starosta
- Harvard Medical School, 25 Shattuck Street, 02115, Boston, MA, USA
| | | | - Alaleh Azhir
- Harvard-MIT Program in Health Sciences and Technology, Harvard Medical School, 77 Massachusetts Ave, 02139, Cambridge, MA, USA
| | | | | | | | | | - Rajet Vatsa
- Harvard Medical School, 25 Shattuck Street, 02115, Boston, MA, USA
- Harvard PhD Program in Health Policy, 14 Story Street, 02138, Cambridge, MA, USA
| | - Allison A Merz-Herrala
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 2356 Sutter Street, 94115, San Francisco, CA, USA
| | - Deborah Bartz
- Harvard Medical School, 25 Shattuck Street, 02115, Boston, MA, USA.
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street CWN-3, 02115, Boston, MA, USA.
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Laestadius LI, Van Hoorn K, Wahl M, Witt A, Carlyle KE, Guidry JPD. Promotion of an Algorithm-Based Tool for Pregnancy Prevention by Instagram Influencers. J Womens Health (Larchmt) 2024; 33:141-151. [PMID: 37976205 DOI: 10.1089/jwh.2023.0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Objective: Despite growing concerns that some digital algorithm-reliant fertility awareness-based methods of pregnancy prevention are marketed in an inaccurate, opaque, and potentially harmful manner online, there has been limited systematic examination of such marketing practices. This article therefore provides an empirical examination of how social media influencers have promoted the fertility tracking tool Daysy on Instagram. We investigate: (1) how the tool is framed in relation to pregnancy prevention using Health Belief Model (HBM) constructs, and (2) the promotional and disclosure practices adopted by influencers. Materials and Methods: We collected Instagram posts mentioning Daysy made between June 2018 and May 2022 using the tool CrowdTangle. Using a qualitative content analysis approach, we coded a random sample of 400 Daysy posts. This yielded 122 Instagram influencer posts promoting Daysy for pregnancy prevention that we coded for promotional content and HBM constructs. Results: Posts originated primarily from Europe (n = 62, 50.82%) and the United States (n = 37, 30.33%). Findings indicate that barriers to use (n = 18, 15.57%) and the severity of risks from unplanned pregnancy (n = 8, 6.56%) were rarely conveyed, whereas benefits of use (n = 122, 100%) and the severity of risks of hormonal contraception (n = 31, 25.41%) were covered more extensively. Only about one third of posts disclosed any formal relationship to the brand Daysy. Conclusions: With many posts emphasizing benefits and obscuring potential limitations, we argue that accurate and transparent information about the effectiveness and limitations of fertility tracking technologies is critical for supporting informed decision-making and, as such, should remain a public health priority.
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Affiliation(s)
- Linnea I Laestadius
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Kelsey Van Hoorn
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Megan Wahl
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Alice Witt
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia
| | - Kellie E Carlyle
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jeanine P D Guidry
- Department Communication and Cognition, Tilburg University, Tilburg, Netherlands
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Prol B, Klein S, Rennie C, Andelija S. Respondent Demographics and Contraceptive Use Patterns in the United States: A National Survey of Family Growth Analysis. Cureus 2024; 16:e53121. [PMID: 38420091 PMCID: PMC10900169 DOI: 10.7759/cureus.53121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Contraception is an important tool for helping to prevent both unintended pregnancies and sexually transmitted infections (STIs). Medical costs related to STIs are high and impose a large burden on both patients and the healthcare system. In addition, unintended pregnancies account for a large portion of pregnancies in the United States (US) and are associated with adverse maternal and infant health outcomes. Both STIs and unintended pregnancies are continuous public health concerns, and this study aims to identify patterns in contraceptive method use in relation to specific social determinants of health. METHODS Utilizing the Centers for Disease Control and Prevention (CDC)'s 2017-2019 National Survey of Family Growth report on current contraceptive status, we isolated data from 3,572 respondents who reported using one of the following contraceptive methods: oral contraceptive pills (OCPs), male condoms, partner's vasectomy, female sterilization, withdrawal, medroxyprogesterone acetate injections (Depo-Provera), hormonal implant, or an intrauterine device (IUD). We analyzed these contraceptive methods among age, race, education, marital status, and insurance status. Data were analyzed in RStudio 2022.02.0 (RStudio Team, RStudio: Integrated Development for R. RStudio, PBC, Boston, MA) through a test of equal proportions for a significance of P < 0.05. A concurrent Yates' continuity correction was performed in order to limit erroneous significant findings based on small sample sizes where applicable. The study conception and data analysis were performed independently with oversight from our preceptor at HCA Florida Brandon Hospital, Brandon, Florida. RESULTS There were statistically significant differences for all our selected methods of contraception across different age groups. There were statistically significant differences for OCPs, male condoms, partner's vasectomy, female sterilization, Depo-Provera, hormonal implant, and IUD across different race groups and different insurance statuses. There were statistically significant differences for OCPs, male condoms, partner's vasectomy, female sterilization, withdrawal, hormonal implant, and IUD across different education levels and different marital statuses. CONCLUSION This analysis highlights gaps that are present in female reproductive autonomy through the statistical differences in contraceptive methods across various demographics and warrants continued focus on the role that social determinants of health play in the prevention of unintended pregnancies and STIs. In order to promote fairness and equality in healthcare, it is essential to increase education on these topics both within and beyond medical settings. This effort aims to provide patients with equitable access to healthcare and attempt to address health disparities that are prevalent in multiple different sectors.
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Affiliation(s)
- Barbara Prol
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Sarah Klein
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Christopher Rennie
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Sanela Andelija
- Department of Obstetrics and Gynecology, HCA Florida Brandon Hospital, Brandon, USA
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6
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Zeglin A, Lazebnik R. Teaching About Contraception: Adolescent Attitudes Surrounding Sexual Education. Open Access J Contracept 2023; 14:181-188. [PMID: 38059115 PMCID: PMC10697143 DOI: 10.2147/oajc.s402443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023] Open
Abstract
Purpose Adolescent pregnancy remains an important public health issue in the United States as it has profound health consequences for both mother and child. Evidence shows that improved contraception use is a critical factor in decreasing rates of adolescent pregnancy. In order to provide effective and engaging contraception education, it is important to understand adolescents' attitudes, questions, and misconceptions around the topic and its delivery. Methods Two searches were conducted using PubMed. Articles were limited to those published in the last 10 years that were written in English. The first search was completed using the search terms "Adolescent attitudes on sex education in the United States", and resulted in 688 articles. The second search was completed using the search terms "Adolescent attitudes on contraception in the United States", and resulted in 840 articles. Articles including contraception but focusing more on HIV, pre-exposure prophylaxis (PrEP), LGBTQ+ health and practices, human papillomavirus (HPV) vaccination, and studies completed in other countries were excluded. Remaining articles were screened by the authors for inclusion, and articles were included if they addressed information on adolescent attitudes on both contraception for pregnancy prevention and sex education, including education by schools, community organizations, the media, peers, parents, and physicians. A total of 56 articles were included in the review. Results The overwhelming theme that emerged from the review is that adolescents prefer comprehensive sex education in a safe space that allows for exploration and questioning. Adolescents want to ask their parents questions about sexual health without fear of punishment, and they desire the opportunity to learn from their physicians in a confidential environment. Conclusion The foundation of effective sex education is a non-judgmental, confidential, and safe space where adolescents can ask questions. There are multiple resources that adolescents use to gather information and establish their preferences and attitudes.
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Affiliation(s)
- Alissa Zeglin
- Internal Medicine and Pediatrics, Froedtert and the Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rina Lazebnik
- General Pediatrics and Adolescent Medicine, Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
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7
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Redman M, Brian J, Wang D. Evaluation of an Online Decision Aid for Selection of Contraceptive Methods. Appl Clin Inform 2023; 14:153-163. [PMID: 36577495 PMCID: PMC9946780 DOI: 10.1055/a-2004-2304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/21/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Knowledge gaps in contraceptives led to their low adoption rates and misuse in young women. The existing online contraception decision aids missed certain decision factors deemed important to college-aged women and did not consistently provide clear and accurate recommendations. To address the needs of young women and the limitations in current tools, we developed a prototype contraception decision aid, My Contraceptive Choice (MCC). This article reports an evaluation study of the MCC tool. METHODS We conducted a mixed methods study: (1) to assess MCC's usefulness and usability through an online survey and a follow-up focus group, and (2) to provide a quantitative examination on the recommendations generated by MCC to match with individual user's needs and preferences through simulated test cases. RESULTS The survey of 150 college-aged women showed very positive responses (reflecting personal preferences, 75%; helping people learn more about birth control methods, 88%; easy to navigate, 91%). The follow-up focus group of 10 survey participants reconfirmed most findings from the survey and provided detailed feedback on certain system functions, such as the inclusion of an important decision factor of weight gain and the efficient hybrid design to integrate the customized recommendations with the side-by-side comparison of all contraceptive methods. Simulated test cases showed that the MCC tool achieved an accuracy of 72% in addressing user preferences and an accuracy of 72% in satisfying user needs, which were significantly better than the existing Planned Parenthood tool. CONCLUSION The initial evaluations suggest that the MCC tool has achieved good levels of usefulness, usability, and appropriate recommendations to address user needs and preferences. Future research is required to assess the performance of the MCC tool in naturalistic settings and to examine the generalizability of the findings to other user populations.
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Affiliation(s)
- Molly Redman
- College of Health Solutions, Arizona State University, Tempe, Arizona, United States
| | - Jennifer Brian
- Barrett, The Honors College, Arizona State University, Tempe, Arizona, United States
| | - Dongwen Wang
- College of Health Solutions, Arizona State University, Tempe, Arizona, United States
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8
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Perelló Capó J, López González G, Rius-Tarruella J, Calaf Alsina J. Real-world satisfaction and menstrual bleeding pattern with available LNG-IUD among Spanish young women. EUR J CONTRACEP REPR 2022; 27:461-472. [PMID: 36148980 DOI: 10.1080/13625187.2022.2112562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/05/2022] [Accepted: 08/09/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the satisfaction and menstrual bleeding pattern with levonorgestrel-releasing intrauterine systems (LNG-IUD) in young women. METHODS A prospective, multicentre, non-interventional study with 1-year follow-up was conducted in Spain. Participants were women between 18 and 30 years old who freely choose any available LNG-IUD for contraception. Satisfaction with LNG-IUD was measured with a 5-point Likert scale. Type of LNG-IUD, menstrual bleeding pattern and satisfaction with it, easiness of insertion and pain during procedure were collected. RESULTS A total of 555 women (37.3% parous, 62.7% nulliparous) (mean age 25.8 ± 3.5) completed the study. After 12 months, 92.4% of women were satisfied or very satisfied with the LNG-IUD, with no differences by parity status, type of IUD or baseline menstrual bleeding pattern. Satisfaction with the LNG-IUD correlated with satisfaction with menstrual bleeding pattern at 12 months. Up to 88.7% of women were satisfied or very satisfied with their menstrual bleeding pattern at 12 months in comparison to 41.5% at baseline (p < 0.001). Adverse events (AE)-related discontinuation rate was low (2.2%). CONCLUSIONS Satisfaction with LNG-IUD is very high among young Spanish women, regardless of parity and menstrual bleeding pattern at baseline.
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Affiliation(s)
- Josep Perelló Capó
- Santa Creu i Sant Pau Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Joaquim Calaf Alsina
- Santa Creu i Sant Pau Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
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9
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Zheng A, Nelson HN, McCall-Hosenfeld JS, Lehman EB, Chuang CH. Recent Intimate Partner Violence and Oral Contraceptive Pill Adherence in a Cohort of Reproductive-Aged Women. J Womens Health (Larchmt) 2022; 31:1703-1709. [PMID: 36126298 PMCID: PMC9805850 DOI: 10.1089/jwh.2021.0622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective: Intimate partner violence (IPV) is an important public health problem that impacts reproductive decision-making. Although previous literature has reported a negative impact on contraceptive adherence overall, this study specifically aims to investigate the association between IPV and oral contraceptive pill (OCP) adherence. Methods: We analyzed baseline survey data from 373 OCP users participating in the MyNewOptions study. Recent IPV was defined as any positive response to HARK, a 4-question tool assessing emotional, sexual, and physical abuse in the past year, or self-report of sexual coercion in the past 6 months. High OCP adherence was defined by self-report of missing ≤1 pill per month, which was then corroborated by pharmacy claims data. Multivariable regression analyses were performed to assess the influence of recent IPV history and patient-level variables on OCP adherence. Results: Just over half of our participants were highly adherent to OCPs (53.6%), and approximately one-quarter reported recent IPV exposure (25.2%). Women with recent IPV were significantly less likely to be OCP adherent than those without IPV (adjusted odds ratio (AOR) 0.54, 95% confidence interval (CI): 0.32-0.92). Protestant religion was also associated with high OCP adherence (AOR 2.41, 95% CI: 1.24-4.65, compared with no religious affiliation), while younger age groups (18-25 and 26-33 years) were less likely to have high OCP adherence compared with the 34-40 age group (AOR 0.45, 95% CI: 0.20-1.00 and AOR 0.40, 95% CI: 0.18-0.91, respectively). Conclusion: Recent IPV exposure is associated with low OCP adherence among women of reproductive age. ClinicalTrials.gov identifier: NCT02100124.
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Affiliation(s)
- Amy Zheng
- Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hallie N. Nelson
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
| | - Jennifer S. McCall-Hosenfeld
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Erik B. Lehman
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Cynthia H. Chuang
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Goueth RC, Maki KG, Babatunde A, Eden KB, Darney BG. Effects of technology-based contraceptive decision aids: a systematic review and meta-analysis. Am J Obstet Gynecol 2022; 227:705-713.e9. [PMID: 35779590 PMCID: PMC9800645 DOI: 10.1016/j.ajog.2022.06.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/22/2022] [Accepted: 06/16/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to conduct a systematic review and meta-analysis of the effects of technology-based decision aids on contraceptive use, continuation, and patient-reported and decision-making outcomes. DATA SOURCES A systematic search was conducted in OVID MEDLINE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, Embase, PsycINFO, and SocINDEX databases from January 2005 to April 2022. Eligible references from a concurrent systematic review evaluating contraceptive care were also included for review. STUDY ELIGIBILITY CRITERIA Studies were included if a contraceptive decision aid was technology-based (ie, mobile/tablet application, web, or computer-based) and assessed contraceptive use and/or continuation or patient-reported outcomes (knowledge, self-efficacy, feasibility/acceptability/usability, decisional conflict). The protocol was registered under the International Prospective Register of Systematic Reviews (CRD42021240755). METHODS Three reviewers independently performed data abstraction and quality appraisal. Dichotomous outcomes (use and continuation) were evaluated with an odds ratio, whereas continuous outcomes (knowledge and self-efficacy) were evaluated with the mean difference. Subgroup analyses were performed for the mode of delivery (mobile and tablet applications vs web and computer-based) and follow-up time (immediate vs >1 month). RESULTS This review included 18 studies evaluating 21 decision aids. Overall, there were higher odds of contraceptive use and/or continuation among decision aid users compared with controls (odds ratio, 1.27; 95% confidence interval, [1.05-1.55]). Use of computer and web-based decision aids was associated with higher odds of contraceptive use and/or continuation (odds ratio, 1.36; 95% confidence interval, [1.08-1.72]) than mobile and tablet decision aids (odds ratio, 1.27; 95% confidence interval, [0.83-1.94]). Decision aid users also had statistically significant higher self-efficacy scores (mean difference, 0.09; 95% confidence interval, [0.05-0.13]), and knowledge scores (mean difference, 0.04; 95% confidence interval, [0.01-0.07]), with immediate measurement of knowledge having higher retention than measurement after 1 month. Other outcomes were evaluated descriptively (eg, feasibility, applicability, decisional conflict) but had little evidence to support a definite conclusion. Overall, the review provided moderate-level evidence for contraceptive use and continuation, knowledge, and self-efficacy. CONCLUSION The use of technology-based contraceptive decision aids to support contraceptive decision-making has positive effects on contraceptive use and continuation, knowledge, and self-efficacy. There was insufficient evidence to support a conclusion about effects on other decision-making outcomes.
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Affiliation(s)
- Rose C Goueth
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR.
| | - Kristin G Maki
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ayo Babatunde
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Karen B Eden
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR; Pacific Northwest Evidence-based Practice Center, Portland, OR
| | - Blair G Darney
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR; School of Public Health, Oregon Health & Science University -Portland State University, Portland, OR; Instituto Nacional de Salud Publica, Center for Population Health Research, Cuernavaca, Mexico
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11
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Chen MJ, Kair LR, Schwarz EB, Creinin MD, Chang JC. Future Pregnancy Considerations after Premature Birth of an Infant Requiring Intensive Care: A Qualitative Study. Womens Health Issues 2022; 32:484-489. [PMID: 35491347 PMCID: PMC9532354 DOI: 10.1016/j.whi.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 03/09/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Postpartum contraception counseling and method use vary widely among patients who had a preterm birth. We performed this study to explore what issues and concerns individuals with preterm infants requiring intensive care describe as influencing their postpartum contraceptive choices. METHODS We conducted a qualitative study using semi-structured interviews with participants who gave birth to a singleton preterm infant admitted to the neonatal intensive care unit (NICU). We explored pregnancy, childbirth, postpartum care, and NICU experiences, as well as future reproductive plans and postpartum contraceptive choices. Two coders used a constant-comparative approach to code transcripts and identify themes. RESULTS We interviewed 26 participants: 4 (15%) gave birth at less than 26, 6 (23%) at 26 to 27 6/7, 8 (31%) at 28 to 31 6/7, and 8 (31%) at 32 to 36 6/7 weeks of gestation. We identified three main themes related to future pregnancy plans and contraception choice. First, participants frequently described their preterm birth and their infants' NICU hospitalization as traumatic experiences that affected plans for future pregnancies. The loss of control in predicting or preventing a future preterm birth and uncertainty about their premature child's future medical needs resulted in participants wanting to avoid going through the same experience with another child. Second, participants chose contraception based on previous personal experiences, desired method features, and advice from others. Last, having a preterm birth did not result in any ambivalence among those who desired permanent contraception. CONCLUSIONS Preterm birth influences future pregnancy plans. When discussing reproductive goals with patients, clinicians should be aware of potential trauma associated with a premature birth, assess for whether patients want to discuss contraception, and center the conversation around individual needs if patients do desire contraceptive counseling.
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Affiliation(s)
- Melissa J Chen
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California.
| | - Laura R Kair
- Department of Pediatrics, University of California, Davis, Sacramento, California
| | - E Bimla Schwarz
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, California
| | - Mitchell D Creinin
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California
| | - Judy C Chang
- Departments of Obstetrics, Gynecology & Reproductive Sciences and Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Espinoza LE. The Examination of Young Mexican American Women’s Contraceptive Use. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2022. [DOI: 10.1177/07399863211070074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this paper is to review all literature on young Mexican American women’s contraceptive use practices in the U.S. to provide an overall picture of the largest Hispanic subgroup. We also discuss how sex education is important to contraceptive use and how parent-child sex communication takes place among young women of this specific population.
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