A qualitative study of factors influencing contraceptive choice among adolescent school-based health center patients.

Year of Publication


Date Published

2015 Oct 15

ISSN Number



<p><strong>STUDY OBJECTIVE: </strong>Long-acting reversible contraceptive (LARC) methods can prevent teen pregnancy yet remain underutilized by adolescents in the United States. Pediatric providers are well positioned to discuss LARC with adolescents, but little is known about how counseling should occur in pediatric primary care settings. We explored adolescent womens' attitudes and experiences with LARCs to inform the development of adolescent-centered LARC counseling strategies.</p>

<p><strong>DESIGN: </strong>Qualitative analysis of one-on-one interviews.</p>

<p><strong>SETTING: </strong>Participants were recruited from two urban school-based, primary care centers.</p>

<p><strong>PARTICIPANTS: </strong>30 adolescent women aged 14-18, diverse in race/ethnicity and sexual experience.</p>

<p><strong>INTERVENTIONS: </strong>Interviews were audio recorded, transcribed, and coded using inductive and deductive coding.</p>

<p><strong>MAIN OUTCOME MEASURE(S): </strong>Major themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches.</p>

<p><strong>RESULTS: </strong>Participants (mean age 16.2 years, range 14-18 years) represented a diverse range of racial/ethnic identities. Half were sexually active and 17% reported current or past LARC use. Five themes emerged regarding key factors that influence LARC uptake, including (1) strong preferences about device-specific characteristics, (2) prior exposure to information about LARC from peers, family members, or health counseling sessions, (3) knowledge gaps about LARC methods that affect informed decision making, (4) personal circumstances or experiences that motivate a desire for effective and/or long-acting contraception, and (5) environmental constraints and supports that may influence adolescent access to LARC.</p>

<p><strong>CONCLUSIONS: </strong>We identified five factors that influence LARC uptake among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings. Words: 248.</p>



Alternate Title

J Pediatr Adolesc Gynecol




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