Long-acting Reversible Contraception for Adolescents and Young Adults: Patient and Provider Perspectives
Long-acting Reversible Contraception for Adolescents and Young Adults: Patient and Provider Perspectives
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DOI：
10.1016/j.jpag.2012.10.006
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发表时间：
2013-04-01
影响因子：
1.8
通讯作者：
Ethier, Kathleen
中科院分区：
文献类型：
--
作者：
Kavanaugh, Megan L.;Frohwirth, Lori;Ethier, Kathleen
研究目的：描述和探索提供者和患者层面的观点长效可逆避孕（LARC）的青少年和年轻人（年龄16-24）。方法：数据收集发生在2011年6月至12月。我们首先对20个提供计划生育服务的公共资助设施的行政主管进行了电话采访。在其中6个地点，我们与设施工作人员进行了6次焦点小组讨论（FGD），并与16- 24岁的设施客户进行了48次深入访谈（IDI）。与工作人员相比，四分之一的年轻妇女确实认为年龄小使她们不符合资格。客户和工作人员一致认为，这些方法的“灵活性”和持续时间是LARC最重要的优势。他们还同意，对插入和取出相关疼痛的恐惧以及负面副作用是不利因素。一些客户认为宫内节育器和植入物的某些方面是有利的，但另一些客户认为是不利的。向年轻患者提供LARC特定服务的常见挑战包括需要额外的时间向年轻患者提供LARC方法的咨询，过时的诊所政策需要多次访问才能获得宫内节育器，以及年轻女性中较高的移除率。最常提到的战略，以解决许多这些挑战是确保补充资金，以支持提供这些服务的年轻patient.Conclusion：将年轻妇女的观点LARC方法纳入公共资助的计划生育设施的努力，提供这些方法，以年轻的人口可能会增加他们的使用年轻女性。
Study Objective: To describe and explore provider- and patient-level perspectives regarding long-acting reversible contraception (LARC) for teens and young adults (ages 16-24).Methods: Data collection occurred between June and December 2011. We first conducted telephone interviews with administrative directors at 20 publicly funded facilities that provide family planning services. At 6 of these sites, we conducted a total of 6 focus group discussions (FGDs) with facility staff and 48 in-depth interviews (IDIs) with facility clients ages 16-24.Results: Staff in the FGDs did not generally equate being a teen with ineligibility for IUDs. In contrast to staff, one-quarter of the young women did perceive young age as rendering them ineligible. Clients and staff agreed that the "forgettable" nature of the methods and their duration were some of LARC's most significant advantages. They also agreed that fear of pain associated with both insertion and removal and negative side effects were disadvantages. Some aspects of IUDs and implants were perceived as advantages by some clients but disadvantages by others. Common challenges to providing LARC-specific services to younger patients included extra time required to counsel young patients about LARC methods, outdated clinic policies requiring multiple visits to obtain IUDs, and a perceived higher removal rate among young women. The most commonly cited strategy for addressing many of these challenges was securing supplementary funding to support the provision of these services to young patients.Conclusion: Incorporating young women's perspectives on LARC methods into publicly funded family planning facilities' efforts to provide these methods to a younger population may increase their use among young women.