EC Method: Determinants for Copper IUD Use and Future Unintended Pregnancy

描述（由申请人提供）：广泛使用的口服左炔诺孕酮用于紧急避孕（EC）并未降低计划外妊娠率。然而，使用铜宫内节育器可能会这样做，因为它是一种更有效的EC方法，也提供了高效的长期避孕。本研究项目的目的是使用定性和定量的研究方法来调查的矛盾心理的妇女承诺长期避孕时，他们目前的EC在计划生育诊所，并评估如何选择口服左炔诺孕酮与铜宫内节育器的EC影响未来的意外怀孕的风险。这项研究将通过确定女性是否接受铜宫内节育器用于EC来解决社会科学和避孕文献中的当前差距，如果是这样，他们是否继续长期使用它，最终，他们是否比选择左炔诺孕酮用于EC的女性计划外怀孕更少。 我们的多学科计划生育研究小组提出了以下目标，以提供所需的信息，这一研究不足的领域：目标1：确定因素，形状低收入妇女的决定使用铜宫内节育器和口服左炔诺孕酮紧急避孕。目的2：比较低收入妇女选择口服左炔诺孕酮与选择铜IUD进行EC的一年计划外妊娠率。目标3：比较选择口服左炔诺孕酮与选择铜IUD进行EC的低收入妇女采用/继续有效避孕的3、6、9和12个月率。 该研究的目的将通过定性研究项目来确定影响女性选择EC的决定的因素，并通过对选择铜IUD或口服左炔诺孕酮的低收入女性进行前瞻性观察试验来实现。我们将在两个参与PPAU的诊所招募所有参加EC的女性，并将对研究参与者进行12个月的随访。 从我们的定性研究中获得的数据将用于我们未来的研究，以创建和评估教育工具的影响，告知妇女提出EC关于他们的选择长期避孕。我们的研究将帮助计划生育从业人员满足长期避孕需求的妇女提出的EC和预防计划外怀孕，在这个高风险群体。 公共卫生相关性：本项目将比较两组接受紧急避孕的妇女：选择铜宫内节育器的妇女和选择计划B（口服左炔诺孕酮）的妇女。我们将确定妇女在这种情况下选择接受长期避孕的原因，并比较长期使用避孕药和未来意外怀孕的情况。该项目将帮助计划生育诊所满足要求紧急避孕的妇女的长期避孕需求，并防止这一高风险群体的意外怀孕。

DESCRIPTION (provided by applicant): Widely available oral levonorgestrel for emergency contraception (EC) has not reduced unplanned pregnancy rates. However, the use of the copper IUD may do so, because it is a much more effective method of EC and also provides highly effective long-term contraception. The objective of this research project is to use qualitative and quantitative research methods to investigate the ambivalence of women about committing to long term contraception when they present for EC at a family planning clinic, and to assess how the selection of oral levonorgestrel versus the copper IUD for EC affects future risk of unplanned pregnancy. This research will address the current gap in the social science and contraceptive literature by determining whether women accept the copper IUD for EC, and if so, whether they continue using it long-term and ultimately, whether they have fewer unplanned pregnancies than women that choose levonorgestrel for EC. Our multi-disciplinary Family Planning Research Group proposes the following aims to provide needed information to this understudied area: Aim 1: Determine factors that shape low-income womens' decisions about using the copper IUD and oral levonorgestrel for emergency contraception. Aim 2: Compare one year unplanned pregnancy rates between low-income women selecting oral levonorgestrel vs. those selecting the copper IUD for EC. Aim 3: Compare 3, 6, 9, and 12-month rates of adoption/continuation of effective contraception between low- income women selecting oral levonorgestrel vs. those selecting the copper IUD for EC. The study aims will be accomplished by a qualitative research project to determine factors that shape decisions made by women presenting for EC, and by a prospective observational trial of low -income women presenting for EC who choose the copper IUD or oral levonorgestrel. We will approach for recruitment all women who present for EC at two participating PPAU clinics and will follow study participants for 12 months. Data obtained from our qualitative research will be used in our future research to create and assess the impact of educational tools informing women presenting for EC about their options for long-term contraception. Our research will aid family planning practitioners to meet the long term contraceptive needs of women presenting for EC and prevent unplanned pregnancies in this high risk group. PUBLIC HEALTH RELEVANCE: This project will compare two groups of women who present for emergency contraception: those who choose the copper IUD and those who choose Plan B (oral levonorgestrel). We will determine the reasons women choose to accept long-term contraception in this setting and compare long-term use of contraception and future unintended pregnancies. This project will help family planning clinics meet the long term contraceptive needs of women presenting for emergency contraception and prevent unplanned pregnancies in this high risk group.