Abstract Study Objective 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 LARCs 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. Design Qualitative analysis of one-on-one interviews. Setting Participants were recruited from 2 urban school-based, primary care centers. Participants Thirty adolescent women aged 14-18 years, diverse in race/ethnicity, and sexual experience. Interventions Interviews were audio-recorded, transcribed, and coded using inductive and deductive coding. Main Outcome Measure Major themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches. Results Participants (mean age, 16.2 years; range, 14-18 years) represented a diverse range of racial and/or ethnic identities. Half (15/30) were sexually active and 17% (5/30) reported current or past LARC use. Five themes emerged regarding key factors that influence LARC choice, including: (1) strong preferences about device-specific characteristics; (2) previous exposure to information about LARCs 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 might influence adolescent access to LARCs. Conclusion We identified 5 factors that influence LARC choice among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings.
An abstract of a study by Serrano et al determining from non-caregiver stakeholders in the child welfare system about their perspectives on what barriers prevent effective discussions about sexual ...health between caregivers and foster youth, strategies they have observed to be effective in facilitating these conversations, and recommendations to better inform the development of effective trainings and STI and pregnancy prevention efforts is presented. Child welfare stakeholders identified several barriers and facilitators to sexual heath discussions between foster/kinship caregivers and youth. This input provides an upstream perspective which can be used to design more effective trainings as well as other types of multilevel interventions to improve reproductive health outcomes among foster youth.
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