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1.
Christina Buckel Ragini Maddipati Melody Goodman Jeffrey F. Peipert Tessa Madden 《Contraception》2019,99(4):222-227
Objective
To compare the proportion of women receiving same-day long-acting reversible contraception (LARC) between two different models of contraceptive provision adapted from the Contraceptive CHOICE Project.Study Design
We used a controlled time-trend study design to compare 502 women receiving structured contraceptive counseling in addition to usual care (“Enhanced Care”) to 506 women receiving counseling plus healthcare provider education and cost support for LARC (“Complete CHOICE”) at three federally qualified health centers. We provided funds to health centers to ensure an “on-the-shelf” supply and no-cost LARC for uninsured women. We recorded the contraceptive method chosen after contraceptive counseling and the healthcare provider appointment as well as the contraceptive method received that day. Among women choosing LARC, we calculated proportions and performed Poisson regression with robust error variance to estimate relative risks for same-day insertion.Results
Participant demographics reflected the health center populations; 69% were black, 66% had a high school diploma or less, 57% were publicly insured, and 75% reported household income less than 101% federal poverty line. There were 153 (30.5%) women in “Enhanced Care” and 273 (54.0%) in “Complete CHOICE” who chose LARC (p<0.01). Among women who chose LARC (n=426), those in “Complete CHOICE” were more likely to receive a same-day insertion, 53.8% vs. 13.7% (RRadj 4.73; 95%CI 3.20–6.98) compared to “Enhanced Care.”Conclusions
A contraceptive care model that included healthcare provider education and cost support for LARC in addition to structured contraceptive counseling resulted in higher rates of same-day LARC insertion compared to contraceptive counseling and usual care alone.Implications
Contraceptive care provision which includes contraceptive counseling, healthcare provider education, and “on-the-shelf”, long-acting reversible contraception facilitate same-day initiation of these methods. Interventions that focus solely on contraceptive counseling do not address other structural barriers to same-day contraceptive provision of all methods including cost and provider practice. 相似文献2.
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Ilaria Morra Cinzia Ferrara Gabriella Sglavo Anna Sansone Gabriele Saccone Lisa Perriera Costantino Di Carlo 《Contraception》2019,99(3):152-154
Objectives
To compare uterine rupture rates in women having a medical abortion receiving gemeprost alone to those receiving mifepristone plus gemeprost.Study design
We reviewed the records of women undergoing medical abortion at 13 0/7–23 6/7?weeks from January 2007 to December 2014 at a single center in Italy. Prior to January 2011, we used gemeprost 1?mg vaginally every 3?h up to a maximum of five doses. After January 2011, we added mifepristone 200 mg orally 24?h prior to the same gemeprost protocol. The primary outcome of the study was the incidence of uterine rupture. We compared the outcome between women receiving gemeprost alone with the combination of gemeprost and mifepristone.Results
One thousand and sixty-one (58.5%) and 753 (41.5%) women underwent medical abortion in the gemeprost-alone and the gemeprost/mifepristone groups, respectively. Five (0.47%) uterine ruptures occurred in the gemeprost and four uterine ruptures occurred in the gemeprost/mifepristone groups, respectively (0.53%) (p=.89). All uterine ruptures occurred in women with prior cesarean delivery.Conclusions
We rep orted no difference in the incidence of uterine rupture between the gemeprost-alone and gemeprost and mifepristone groups.Implications
Uterine rupture is a rare complication of second-trimester medical abortion with gemeprost. Use of mifepristone prior to gemeprost does not affect this risk. 相似文献4.
Benjamin P. Brown Julie Chor Luciana E. Hebert M. Elizabeth Webb Amy K. Whitaker 《Contraception》2019,99(4):228-232
Objectives
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.Study design
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.Results
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.Conclusions
Negative LARC stories are common among women presenting for abortion at our institution and may influence patient uptake of these methods.ImplicationsThis 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. 相似文献5.
Willi Horner-Johnson Esther L. Moe Ryan C. Stoner Krystal A. Klein Alison B. Edelman Karen B. Eden Elena M. Andresen Aaron B. Caughey Jeanne-Marie Guise 《Disability and health journal》2019,12(2):139-154
Background
Women spend most of their reproductive years avoiding pregnancy. However, we know little about contraceptive knowledge and use among women with disabilities, or about strategies to improve contraceptive knowledge and decision-making in this population.Objective
To systematically review published literature on women with disabilities and: 1) contraceptive knowledge; 2) attitudes and preferences regarding contraception; 3) contraceptive use; 4) barriers and facilitators to informed contraceptive use; and 5) effectiveness of interventions to improve informed contraceptive decision-making and use.Methods
We searched MEDLINE, PsychINFO, the Cochrane Library, CINAHL, and ERIC databases from inception through December 2017. Two reviewers independently reviewed studies for eligibility, abstracted study data, and assessed risk of bias following PRISMA guidance.Results
We reviewed 11,659 citations to identify 62 publications of 54 unique studies (total n of women with disabilities?=?21,246). No standard definition of disability existed across studies. The majority of studies focused on women with intellectual disabilities (ID). Women with ID and those who were deaf or hard-of-hearing had lower knowledge of contraceptive methods than women without disabilities. Estimates of contraceptive use varied widely, with some evidence that women with disabilities may use a narrower range of methods. Five of six studies evaluating educational interventions to increase contraceptive knowledge or use reported post-intervention improvements.Conclusions
Women with disabilities may use a more narrow mix of contraceptive methods and are often less knowledgeable about contraceptives than women without disabilities. Interventions to improve knowledge show some promise. A lack of data exists on contraceptive preferences among women with disabilities. 相似文献6.
Somesh Kumar Ashish Srivastava Surendra Sharma Vivek Yadav Atul Mittal Young–Mi Kim Angela Nash-Mercado Sijmen A. Reijneveld Bulbul Sood 《Contraception》2019,99(4):212-216
Objective
To evaluate outcomes of a national postpartum (within 48?h of delivery) copper intrauterine device placement (PPCuIUD) program in six “high-focus states” with high unmet family planning need in India.Study design
We identified high-volume district hospitals that provided PPCuIUD in six (Bihar, Jharkhand, Uttar Pradesh, Uttarakhand, Madhya Pradesh and Chhattisgarh) Indian states (two per state). Each selected hospital maintained a list of PPCuIUD acceptors with contact phone numbers. We randomly selected 100 women at each site for inclusion in a telephone survey of IUD outcomes at 1 year. Questions regarded IUD expulsion, discontinuation because of symptoms (e.g., pain, bleeding, discharge), discontinuation for other reasons and use of alternative contraception if discontinuation reported.Results
We could contact 844 of the 1200 randomly selected women, of whom 673 (79.7%) had postplacental insertion (within 10?min of delivery), while 171 (20.3%) had an early postpartum insertion (between 10?min to 48?h after delivery). Of those contacted, 530 women (62.8%) reported continuing with the method beyond 1 year, 63 (7.5%) reported having an expulsion, 163 (19.3%) reported having removals for associated side effects (bleeding, pain and discharge), and 88 (10.4%) reported having removals for other reasons. After removal or expulsion, almost half of the women (46.5%) did not switch to any other modern contraceptive method.Conclusion
PPCuIUD continuation rate at 1?year was 62.8%. Most removals within 1 year were due to associated side effects. Almost half of the women discontinuing PPCuIUD did not switch to an alternative modern contraceptive method.Implications
The 1-year continuation rate of PPCuIUD achieved through a large-scale national program in India is satisfactory. The program though needs to address the low uptake of other modern contraceptive methods after discontinuation. 相似文献7.
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Abigail R Greenleaf Saifuddin Ahmed Caroline Moreau Georges Guiella Yoonjoung Choi 《Contraception》2019,99(3):170-174
Objectives
With over 420 million unique cell phone subscribers in sub-Saharan Africa, the opportunities to use personal cell phones for public health research and interventions are increasing. We assess the association between cell phone ownership and modern contraceptive use among women in Burkina Faso to understand the opportunity to track family planning indicators using cell phone surveys or provide family planning interventions remotely.Study design
We analyzed data from a cross-sectional, nationally representative population-based survey of women of reproductive age in Burkina Faso, the Performance Monitoring and Accountability 2020 Round 4, which was conducted between November 2016 and January 2017.Results
Among the 3215 female respondents aged 15 to 49?years, 47% reported cell phone ownership. Overall, 22% of women reported current modern contraceptive use. Women who owned a cell phone were more likely to report modern contraceptive use than those who did not (29% versus 15%). Adjusted for covariates (age, wealth, education, area of residence and marital status), the odds of reporting modern contraceptive use were 68% higher among cell phone owners compared to nonowners (odds ratio=1.68, 95% confidence interval 1.3–2.1). Method mix was substantially more diverse among those who owned cell phones compared to their counterparts.Conclusions
The study shows that cell phone ownership is significantly associated with modern contraceptive use in Burkina Faso, even after adjusting for women's sociodemographic characteristics. These results suggest that cell phone ownership selectivity and associated biases need to be addressed when planning family planning programs or conducting surveys using cell phones.Implications
Cell phones can be used for myriad family planning purposes, from confidential data collection to contraceptive promotion and knowledge dissemination, but ownership bias is significant. A cell-phone-based intervention or population-based survey is unlikely to reach a critical mass of the population at highest risk for unintended pregnancy. 相似文献9.
Babayemi O. Olakunde Nadia A. Sam-Agudu Tanviben Y. Patel Aaron T. Hunt Aurora M. Buffington Tara D. Phebus Ebube Onwasigwe Echezona E. Ezeanolue 《Contraception》2019,99(4):205-211
Objective
Uptake of permanent contraception among women remains low in sub-Saharan Africa compared to other regions. We aimed to synthesize available evidence on barriers to, and facilitators of permanent contraception with regards to tubal ligation among women in sub-Saharan Africa.Study Design
We reviewed literature on tubal ligation among African women published between January 1, 2000 and October 30, 2017. We searched PubMed, Global health, EMBASE, Web of science, and Google scholar for quantitative, qualitative, and mixed methods studies which reported on barriers and/or facilitators to uptake of tubal ligation in sub-Saharan Africa. Finally, we conducted a narrative synthesis and categorized our findings using a framework based on the social ecological model.Results
We included 48 articles in the review. Identified barriers to tubal ligation among women included individual-level (myths and misconceptions, fear of surgery, irreversibility of procedure, religious beliefs), interpersonal-level (male partner disapproval), and organizational-level (lack of healthcare worker expertise and equipment) factors. Facilitating factors included achievement of desired family size and perceived effectiveness (individual-level), supportive male partners and knowing other women with permanent contraception experience (interpersonal-level), and finally, subsidized cost of the procedure and task-sharing with lower cadre healthcare workers (organizational-level).Conclusions
Barriers to, and facilitators of permanent contraception among women in sub-Saharan Africa are multilevel in nature. Strategies countering these barriers should be prioritized, as effective contraception can promote women’s health and economic development in sub-Saharan Africa. In addition to these strategies, more quantitative research is needed to further understand patient-level factors associated with uptake of permanent contraception among women. 相似文献10.
Joseph Friedman Biani Saavedra-Avendaño Raffaela Schiavon Lily Alexander Patricio Sanhueza Ranulfo Rios-Polanco Laura Garcia-Martinez Blair G. Darney 《Contraception》2019,99(3):160-164
Objectives
In the Mexico City Metropolitan Area, only women in the city center have local access to legal first-trimester abortion. We quantify how this legislative discrepancy affects access to legal, public-sector abortion across the metropolitan area.Study design
In this observational study, we used a dataset representing 67.2% of all abortions occurring between 2010 and 2012 in Mexico City's public abortion program and census population data. We calculate utilization rates for 75 municipalities in the metropolitan area for 2010–2012. We compare utilization between municipalities with and without local legal access, adjusting for differences in sociodemographic drivers of abortion demand. We explore the effects of local abortion legality, travel time and socioeconomic status (SES).Results
Women who had to travel into the city center for legal abortions used services at only 18.6% (95% CI 13.3%–33.0%) of the expected rate if they had local access, adjusting for sociodemographic factors. After controlling for travel time and SES, women who lived where abortion is illegal had a 58.6% (95% CI 21.5%–78.1%) reduction in access, and each additional 15?min of travel further reduced access by 33.7% (95% CI 18.2%–46.3%). Women who travel to seek legal abortions are more likely to have completed secondary education compared to other reproductive age women in their municipality (p?=?<.00001).Conclusions
We find that, in the Mexico City Metropolitan Area, both living where abortion is illegal and having to travel further to access services substantially reduce access to legal, public-sector abortion. These burdens disproportionately affect women of lower SES.Implications
Both local legality and proximate access are key to ensuring equity in access to public-sector abortion. Legalization of abortion services across the greater Mexico City Metropolitan Area has the potential to increase equity in utilization and meet unmet demand for legal abortion. 相似文献11.
Sarah Asad Courtney Hebert Rebecca Andridge Nghia Nguyen Maria F. Gallo 《Contraception》2019,99(3):165-169
Objectives
To calculate the prevalence and identify correlates of unmet need for contraception and to assess whether prevalence of use of effective contraception and long-acting reversible contraception (LARC) has changed over time among married or cohabiting, reproductive-age women in Vietnam.Methods
Study population was drawn from nationally representative Multiple Indicator Cluster Surveys conducted in 2000, 2006, 2011 and 2014. Unmet need for contraception was defined as occurring when a fecund, married or cohabiting woman is not using any method of contraception but either does not want children or wants to delay birth for at least 1 year or until marriage. Following the ranking of method effectiveness by the Centers for Disease Control and Prevention, we defined “effective contraception” as implant, intrauterine device, male and female sterilization, injectable, pill, patch, ring or diaphragm. We used multivariable logistic regression to identify correlates of unmet need for contraception in 2014 and Cochran–Armitage trend tests to assess changes in effective contraception and LARC use from 2000 to 2014. All analyses used survey weights to account for the complex sampling design.Results
In 2014, 4.3% of married or cohabiting, reproductive-age women had unmet need for contraception. Multivariable analysis showed that age, education and number of children ever born were statistically significant correlates of unmet need for contraception. Use of effective contraception statistically significantly declined from 53.0% in 2000 to 45.7% in 2014 (p<.0001). Similarly, LARC declined from 39.6% in 2000 to 30.0% in 2014 (p<.0001). After adjusting for age, education, residence and having at least one son, these secular trends remained.Conclusion
Findings indicate that effective contraception and LARC use have decreased among married or cohabiting women of reproductive age in Vietnam. Correlates of unmet need for contraception should be used to inform interventions to prevent unintended pregnancy.Implications
Although the prevalence of unmet need for contraception was low (4.3%) in 2014, the use of effective contraception and long-acting reversible contraception declined among reproductive-age, married or cohabiting women in Vietnam from 2000 to 2014. This finding is particularly striking given the economic growth in the nation during this time frame. 相似文献12.
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Vincent Guilamo-Ramos Alex S. Bowman Adam Benzekri Yumary Ruiz Oscar Beltran 《Contraception》2019,99(3):179-183
Objective
The study describes maternal and adolescent perspectives on sexual decision making and the role of mothers in shaping use of contraception for the prevention of unplanned pregnancies and sexually transmitted infections (STIs) among older Latino adolescents.Study design
Researchers used a semistructured interview guide to conduct focus group discussions with 21 mother–adolescent Latino dyads (n=42). Latino adolescents ages 17–19 were eligible for the study. We recruited families from the South Bronx, New York City, using area sampling methodology. For analysis of qualitative data, we used the framework method involving open coding, identification of dominant themes, refining of codebooks and indexing.Results
Overwhelmingly, results suggest asymmetric priorities and preferences regarding maternal involvement in older adolescent sexual and contraceptive decision making. Mothers primarily employed practices designed to prevent adolescent sexual activity. Most teens reported already having experienced sexual debut and were currently sexually active. Adolescents expressed a strong interest in practical support for sexual decision making, including maternal guidance regarding effective access to and use of contraception. Mothers offered limited guidance or support with such matters. Maternal views focused entirely on the health and social consequences of sex in lieu of specific guidance on contraception for older sexually active adolescents. The findings highlight a missed opportunity for Latino mothers to support their older adolescent children to prevent unplanned pregnancies, STIs and HIV.Conclusion
Mothers have the potential to positively shape adolescent contraceptive decision making and behavior. Misalignment of priorities between mothers and adolescents diminishes the potential of reducing adolescent sexual and reproductive health (SRH) disparities.Implications
Mothers are influential in reducing adolescent SRH risk. However, asymmetric priorities among Latino adolescents and their mothers regarding support for SRH reduce likelihood of reducing adolescent negative SRH outcomes and supporting adolescent health. Programs supporting better alignment of maternal guidance and adolescent SRH needs are warranted. 相似文献17.
Introduction
In July 2015, the antiabortion Center for Medical Progress released a covertly filmed video of a Planned Parenthood official discussing the dispensation of postabortion remains for research, a practice the general public was not familiar with. Research shows that people use preexisting frameworks (such as support for or opposition to abortion rights) to make sense of new information. We examine the presence and use of abortion-related movement heuristics, language, and framing in the lay public's engagement with this video and their response to it.Methods
Using modified grounded theory, we analyzed user comments on five online news articles about the video, drawn from sources representing different segments of the spectrum of support for abortion rights, to serve as a proxy for the public conversation.Results
Commenters used language and framing consistent with the abortion rights and antiabortion social movements to debate basic information about this practice (i.e., the language of “fetal tissue” vs “baby parts” and whether the abortion provider profited from the exchange). Discussion of the abortion provider's casual demeanor, however, did not always use movement language and association consistently, with some commenters demonstrating inconsistency between their support for abortion and response to the video.Conclusions
Online commenters largely used language consistent with the contemporary abortion movements’ ideological frames in their engagement about the video. The presence of this language suggests that people may draw on existing frameworks about abortion when they engage with abortion-related information, which could have implications for efforts to address abortion misinformation. 相似文献18.
Christine M. Olson Myla S. Strawderman Meredith L. Graham 《Journal of nutrition education and behavior》2019,51(4):391-399
Objectives
To describe (1) the use of a diet goal-setting tool in a self-directed online intervention aimed at promoting a healthy lifestyle, and (2) the association of tool use with gestational weight gain (GWG).Design
Cross-sectional analysis of data from the intervention group in a randomized effectiveness trial.Setting
An urban county in the northeastern US.Participants
A total of 898 healthy pregnant women aged 18–35 years with body mass indexes of (BMI) ≥18.5 and <35; 39.1% were low-income.Main Outcome Measures
Physical, sociodemographic, and psychosocial characteristics; use of tool features; and GWG.Analysis
Frequencies, chi-square tests of independence, and regression analysis.Results
Use of the online dietary tool was 45.1% completed the assessment, 35.3% set a goal, and 22.6% engaged in self-monitoring. Among women with normal BMI, setting ≥2 goals and engaging in self-monitoring were significantly (P < .05) associated with less GWG. Among women with higher BMI, setting ≥2 goals was significantly associated with greater GWG.Conclusions and Implications
Although online diet goal setting is a potentially effective weight management tool for pregnant women with normal BMI, findings suggest that it may not be for higher-BMI women. Additional research is needed to explain this finding. 相似文献19.
Hervé Lefevre Stéphanie Samain Nour Ibrahim Christine Fourmaux Anne Tonelli Sébastien Rouget Emmanuelle Mimoun Renaud De Tournemire Marie Devernay Marie Rose Moro Jonathan Lachal 《Vaccine》2019,37(13):1792-1798
Objective
Vaccination coverage against HPV in France is among the lowest in the industrialized world, although the public authorities have recently become aware of this issue. Few studies have looked at teenaged girls’ representations of this vaccination, even though they are the most concerned by it. This qualitative study explored the experiences and representations of HPV vaccination by adolescent girls seeing doctors at least occasionally.Study Design
We used a written essay question to explore this issue among 101 adolescent girls at six urban medical centers and a semi-structured interview to discuss it in further depth with five of them. The analysis was lexicometric (ALCESTE®) and phenomenological (Interpretative Phenomenological Analysis).Results
These results are organized around four superordinate themes: the teenage girls' factual knowledge about this vaccine, their motives for and obstacles to vaccination, their involvement in this decision, and finally the need for information about and solutions to this issue.Conclusions
Teenage girls know little about this vaccine and are more sensitive to the emotional discourse that surrounds it than to rational knowledge about it. The requirement for parental authorization for this vaccine reinforces the girls' lack of investment. Vaccination programs should integrate the HPV vaccine more thoroughly into general prevention concerning sexual health and should send a strong signal by offering minors anonymous vaccination free of charge, as is already the case in France for requests for contraception, the morning-after pill, elective abortion, and screening and treatment of sexually transmitted infections. 相似文献20.
Caroline Heller Krista M. Perreira Adele Shartzer Emily M. Johnston Brigette Courtot 《Women's health issues》2019,29(2):161-169