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

描述（由申请人提供）：广泛用于紧急避孕（EC）的口服左炔诺孕酮并没有降低意外怀孕率。然而，使用铜宫内节育器可以做到这一点，因为它是一种更有效的EC方法，也提供了非常有效的长期避孕。本研究项目的目的是使用定性和定量研究方法调查妇女在计划生育诊所接受EC时对长期避孕的矛盾心理，并评估口服左炔诺孕酮和铜宫内节育器对EC的选择如何影响未来意外怀孕的风险。本研究将通过确定妇女是否接受铜宫内节育器治疗EC，如果接受，是否继续长期使用，最终是否比选择左炔诺孕酮治疗EC的妇女有更少的意外怀孕，来解决目前社会科学和避孕文献中的差距。我们的多学科计划生育研究小组提出以下目标，为这一研究不足的领域提供所需的信息：目标1：确定影响低收入妇女决定使用铜宫内节育器和口服左炔诺孕酮紧急避孕的因素。目的2：比较选择口服左炔诺孕酮的低收入妇女与选择铜宫内节育器的低收入妇女一年计划外妊娠率。目的3：比较选择口服左炔诺孕酮的低收入妇女与选择铜宫内节育器的低收入妇女的3、6、9和12个月有效避孕的采纳率/持续率。该研究的目的将通过定性研究项目来确定影响EC患者决策的因素，并通过对选择铜宫内节育器或口服左炔诺孕酮的低收入EC患者进行前瞻性观察试验来实现。我们将招募所有在两家参与PPAU诊所接受EC的女性，并对研究参与者进行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中，以创建和评估教育工具的影响，这些工具向前来EC的妇女告知她们长期避孕的选择。我们的研究将帮助计划生育从业者满足EC患者的长期避孕需求，并预防这一高危人群的意外怀孕。

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.