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Harper CC, Yarger J, Mangurian C, Hopkins K, Rossetto I, Elmes S, Hecht HK, Sanchez A, Hernandez R, Shokat M, Steinberg JR. Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults. J Womens Health (Larchmt) 2024; 33:870-878. [PMID: 38465503 DOI: 10.1089/jwh.2023.0549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Background: Symptoms of mental distress increased sharply during the COVID-19 pandemic, especially among older adolescents and young adults. Mental health distress may make it more challenging for young people to seek other needed health care, including contraception. This study explored the association of symptoms of depression, anxiety, and stress with delays in getting a contraceptive method or prescription. Materials and Methods: Data from a supplementary study (May 15, 2020-March 20, 2023) to a cluster randomized trial in 29 sites in Texas and California were used. The diverse study sample included community college students assigned female at birth of ages 18-29 years (n = 1,665 with 7,023 observations over time). We measured the association of depression (CES-D [Center for Epidemiologic Studies Depression Scale]) or anxiety and stress (DASS-21 [Depression Anxiety Stress Scales]) symptoms with delayed contraceptive care-seeking with mixed-effects multivariable regression with random effects for individual and site. We controlled for age and sociodemographic factors important for access to care. Results: Over one-third of participants (35%) reported they delayed getting the contraceptive method they needed. Multivariable regression results showed increased odds of delayed contraceptive care among participants with symptoms of depression (adjusted odds ratio [aOR] 1.58, 95% confidence interval [CI] 1.27-1.96). Likewise, delays were associated with anxiety and stress symptoms (aOR 1.46, 95% CI 1.17-1.82). Adolescents were more likely to delay seeking contraception than young adults (aOR 1.32, 95% CI 1.07-1.63). Conclusions: Results showed a strong association between mental distress and delayed contraception. Interventions are needed to increase contraceptive access for young people delaying care, along with supportive mental health care services, including for adolescents who face elevated odds of delay. ClinicalTrials.gov Identifier: NCT03519685.
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Affiliation(s)
- Cynthia C Harper
- Department of Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA
| | - Jennifer Yarger
- Department of Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA
| | - Christina Mangurian
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, School of Medicine, University of California, San Francisco, California, USA
| | - Kristine Hopkins
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Irene Rossetto
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Sarah Elmes
- Department of Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA
| | - Hannah K Hecht
- Department of Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA
| | - Audrey Sanchez
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | | | - Mitra Shokat
- School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Julia R Steinberg
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
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Fan H, Wang Y, Gao J, Peng Z, Coyte PC. The Effect of a Long-Term Care Insurance Program on Subjective Well-Being of Older Adults with a Disability: Quasi-Experimental Evidence from China. J Appl Gerontol 2023; 42:438-446. [PMID: 36366866 DOI: 10.1177/07334648221138282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
China launched its long-term care insurance (LTCI) program for older adults in 2016. Although the scheme has shown some promising outcomes, little is known about whether it improves subjective well-being. This study explored this topic among older persons with a disability and identified the underlying mechanisms associated with the channel of this effect using data from a national survey. The LTCI program was shown to improve the subjective well-being among older persons with a disability and this effect increased over time. The LTCI program has great positive effect among women and those who lived alone compared to their counterparts. Mechanism analysis revealed that the main channel by which the LTCI program has positive effect occurred through the satisfaction of long-term care needs and improved self-reported health. This study suggests promising benefits of the LTCI program for older Chinese adults.
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Affiliation(s)
- Hongli Fan
- School of Insurance, 47855Shandong University of Finance and Economics, Jinan, China
| | - Yingcheng Wang
- School of Insurance, 47855Shandong University of Finance and Economics, Jinan, China
| | - Jinyan Gao
- School of Insurance, 47855Shandong University of Finance and Economics, Jinan, China
| | - Zixuan Peng
- Institute of Health Policy, Management and Evaluation, 7938University of Toronto, Toronto, ON, Canada
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, 7938University of Toronto, Toronto, ON, Canada
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