Evaluating Provider Self-Disclosure in Adolescent Contraception Counseling

Abstract

This study aimed to assess the prevalence of provider self-disclosure (PSD) of intrauterine device (IUD) usage with adolescent patients and identify the content and context of their PSD. A cross-sectional study PARTICIPANTS: Providers sex-assigned female at birth who counsel adolescents or young adults on contraception INTERVENTION: Participants were asked to voluntarily complete a web-based survey disseminated through the North American Society for Pediatric and Adolescent Gynecology listserve. PSD in relation to IUD use (IUD-PSD) and other contraception use RESULTS: Eighty-five respondents completed the survey. Thirty-one (36%) reported that PSD of contraception usage to adolescents is usually or always appropriate, 32 (38%) as neither appropriate nor inappropriate, and 22 (26%) as usually or always inappropriate. Regarding IUDs, 61 respondents have used or are currently using an IUD. Forty-four (72%) IUD users have self-disclosed IUD use to an adolescent by choice, 6 (10%) have only by patient request, and 9 (15%) have never self-disclosed use. Out of 52 IUD users, 32 (62%) stated that IUD-PSD most often occurs when the patient has decided on the IUD but has questions, 25 (48%) when the patient was debating between fewer methods, and 14 (27%) when discussing all contraceptive options with the patient. Respondents who choose to self-disclose IUD use are more likely to disclose other contraceptive use compared with those who do not self-disclose IUD use (P < 0.001) and are also more likely to disclose personal family aspects (P < 0.001). Self-disclosure of IUD usage is relatively common among study respondents and occurs most often after a patient has decided on an IUD.