Contraceptive Counseling Research Articles

Validation of a measure to assess decision-making autonomy in family planning services in three low- and middle-income countries: The Family Planning Autonomous Decision-Making scale (FP-ADM).

Integrating measures of respectful care is an important priority in family planning programs, aligned with maternal health efforts. Ensuring women can make autonomous reproductive health decisions is an important indicator of respectful care. While scales have been developed and validated in family planning for dimensions of person-centered care, none focus specifically on decision-making autonomy. The Mothers Autonomy in Decision-Making (MADM) scale measures autonomy in decision-making during maternity care. We adapted the MADM scale to measure autonomy surrounding a woman's decision to use a contraceptive method within the context of contraceptive counselling. This study presents a psychometric validation of the Family Planning Autonomous Decision-Making (FP-ADM) scale using data from Argentina, Ghana, and India. We used cross-sectional data from women in four subnational areas in Argentina (n = 890), Ghana (n = 1,114), and India (n = 1,130). In each area, 20 primary sampling units (PSUs) were randomly selected based on probability proportional to size. Households were randomly selected in Ghana and India. In Argentina, all facilities providing reproductive and maternal health services within selected PSUs were included and women were randomly selected upon exiting the facility. Interviews were conducted with a sample of 360 women per district. In total, 890 women completed the FP-ADM in Argentina, 1,114 in Ghana and 1,130 in India. To measure autonomous decision-making within FP service delivery, we adapted the items of the MADM scale to focus on family planning. To assess the scale's psychometric properties, we first examined the eigenvalues and conducted a parallel analysis to determine the number of factors. We then conducted exploratory factor analysis to determine which items to retain. The resulting factors were then identified based on the corresponding items. Internal consistency reliability was assessed with Cronbach's alpha. We assessed both convergent and divergent construct validity by examining associations with expected outcomes related to the underlying construct. The Eigenvalues and parallel analysis suggested a two-factor solution. The two underlying dimensions of the construct were identified as "Bidirectional Exchange of Information" (Factor 1) and "Empowered Choice" (Factor 2). Cronbach's alpha was calculated for the full scale and each subscale. Results suggested good internal consistency of the scale. There was a strong, significant positive association between whether a woman expressed satisfaction with quality of care received from the healthcare provider and her FP-ADM score in all three countries and a significant negative association between a woman's FP-ADM score and her stated desire to switch contraceptive methods in the future. Our results suggest the FP-ADM is a valid instrument to assess decision-making autonomy in contraceptive counseling and service delivery in diverse low- and middle-income countries. The scale evidenced strong construct, convergent, and divergent validity and high internal consistency reliability. Use of the FP-ADM scale could contribute to improved measurement of person-centered family planning services.

Association Between Facility and Clinician Characteristics and Family Planning Services Provided During U.S. Outpatient Care Visits.

Recent guidelines from the Centers for Disease Control and Prevention emphasize the importance of access to comprehensive family planning services and recommend patient-centered contraceptive counseling be incorporated into routine primary care visits for reproductive-age individuals. This study aims to describe family planning service provision in outpatient care settings and assess differences by facility and clinician characteristics. Using National Ambulatory Medical Care Survey data, a nationally representative survey of outpatient care visits, we assessed family planning service provision by facility location, facility type, physician specialty, types of clinicians seen, and whether the patient was seen by their primary care provider. We used random intercept logistic regression with robust standard errors, adjusting for patient characteristics, and state and year fixed effects. The analytic sample included 53,489 patient visits with reproductive-age (15-49years) individuals between 2011 and 2019. Family planning services were provided at 8% of total sampled visits and were more likely to be provided in urban compared with rural areas (adjusted odds ratio, 1.45; p=.02) and at community health centers compared with private physician practices (adjusted odds ratio, 1.74; p=.00). Family planning services were also more likely to be provided when the patient saw a physician assistant or nurse compared with only a physician. After controlling for observed covariates, measures of between-clinician heterogeneity indicate wide variation in which clinicians provided family planning services. Family planning services were more likely to be provided in urban areas, at community health centers, and when patients received team-based care. The wide variation between clinicians suggests a need to better incorporate family planning services into primary care and other outpatient settings to meet patient needs and preferences.

Contraception and Abortion Care for People Living With HIV: A Clinical Guide for Reproductive Health Practitioners.

People capable of pregnancy are disproportionately affected by HIV. Family planning needs and services are often unmet in this population, and clinical care guidelines regarding contraceptive options and abortion care are not well elucidated. Individuals living with HIV often face unique barriers in accessing contraception and abortion services due to internalized stigma, medically complex care (eg, drug-drug interactions, adverse effects of antiretroviral therapy), and distrust of health care providers. There is also a lack of clarity among reproductive health, primary, and infectious disease care providers on best-practice contraceptive counseling and contraceptive care for individuals living with HIV, given limited opportunities to enhance expertise in reproductive infectious disease. In this review, we summarize existing and updated evidence and clinical considerations regarding contraceptive counseling and abortion care in this population.

Qualitative Research on Social Media Addictions of Psychological Counsellor Candidates

Social media (SM), which is frequently preferred by young people, poses a risk of addiction when used excessively and unconsciously. Having self-awareness and becoming digitally literate, unlike other university students, is essential for psychological counselor candidates (PCC) in terms of preventive counseling they will do in the institutions they will work in the future. Therefore, the aim of this study was to compare young people who use social media intensively or less by examining the views of PCC with high or low levels of social media addiction (SMA). This study presents a phenomenological approach to qualitative research. The SMA Scale-Adult Form was applied to the students (total 138 students) from the Department of Psychological Counselling and Guidance at Artvin Çoruh University. Focus group interviews were conducted with 20 PCC students who got the highest (11 students) and lowest (9 students) points on the scale, and extreme case and outlier samplings were preferred from the interviews. The data collected through the interviews were analyzed using content analysis. As a result of the study, SMA and related addiction symptoms have been observed in the PCC. The opinions of the PCC with low and high SMA levels varied in terms of the frequency of SM usage, application preferences, usage purposes, emotions, and opinions on the effect of SM on professional use. The results of the study are discussed and interpreted in line with the relevant literature, and recommendations are presented.

The 35th anniversary of the North-Western District center for AIDS prevention and control at the Saint Petersburg Pasteur Institute

The organization of the North-Western District Center for AIDS Prevention and Control (AIDS Center) originates from the onset of the HIV epidemic in the Russian Federation. Over the 35 years of work, the staff of the AIDS Center has made an invaluable contribution to the development of HIV diagnostics, the introduction of new clinical and preventive technologies, patient counseling, and training of qualified personnel. The anniversary article highlights the main stages regarding establishment of the AIDS Center as a structural unit of the Saint Petersburg Pasteur Research Institute. The versatile naturally multidisciplinary functions and tasks related to the AIDS Center organization, its major Russia-wide and global achievements are considered. Special attention is paid to the long-term international cooperation, the results of diverse implemented programs and projects supported by the World Health Organization (WHO) as well as the Joint United Nations Programme on HIV/AIDS. The AIDS Center continues to cooperate with the main scientific facilities such as the Pavlov First Saint Petersburg State Medical University, Institute of Experimental Medicine, N.P. Bekhtereva Institute of the Human Brain of the Russian Academy of Sciences, etc. The ongoing joint research invariably contributes to assessing the epidemiology and clinical course of various viral infections and comorbid conditions. The knowledge acquired becomes regularly summarized and published in a series of monographs, journal articles being presented demonstrated at conferences of various levels. Currently, the AIDS Center is represented by several structural divisions continuing to conduct practical and scientific activities on investigating HIV and viral hepatitis.

Structured contraceptive counselling- a workshop for student midwives and clinical midwives focusing on informed decision-making on contraceptive methods

Structured contraceptive counselling- a workshop for student midwives and clinical midwives focusing on informed decision-making on contraceptive methods

Shortcomings and disparities in contraception counseling and use by hypertensive individuals at risk for unintended pregnancy: a comparative analysis of the National Survey of Family Growth

BackgroundHypertension is a leading cause of adverse pregnancy outcomes. These outcomes disproportionately affect Black individuals. Reproductive life planning that includes patient-centered contraception counseling could mitigate the impact of unintended pregnancy. ObjectiveThe primary objective of the study is to compare contraception counseling and use among hypertensive and non-hypertensive individuals at risk for unintended pregnancy. Our secondary objectives are 1) to evaluate the effect of race on the probability of counseling and the use of contraception and 2) to evaluate the methods used by individuals with hypertension. MethodsData from the 2015-2017 and 2017-2019 National Survey of Family Growth Female Respondent Files were used to analyze whether individuals who reported being informed of having high blood pressure within the prior 12 months received counseling about contraception or received a contraceptive method. Covariates considered in the analysis included age, race, parity, educational attainment, body mass index, smoking, diabetes, and experience with social determinants of health (SDH). The SDH covariate was based on reported experiences within five SDH domains: food security, housing stability, financial security, transportation access, and childcare needs. Linear probability models were employed to estimate the adjusted probability of receiving counseling and the use of a contraceptive. Using difference in difference analyses, we compared the change in counseling and use between hypertensive and non-hypertensive respondents by race, relative to White respondents. ResultsOf the 8,625 subjects analyzed, 771 (9%) were hypertensive. Contraception counseling was received by 26.2% (95%CI 20.4-31.9) of hypertensive individuals and 20.7% (95%CI 19.3-22.2) of non-hypertensive individuals. Contraception use was reported by 39.8% (95% CI 33.2-46.5) of hypertensive and 35.3% (95%CI 33.3-37.2) of non-hypertensive individuals. The linear probability model adjusting for age, parity, education attainment, body mass index, smoking, diabetes and SDH indicated that hypertensive individuals were 8 percentage points (95%CI 3, 18 percentage points). more likely to receive counseling and 9 percentage points (95%CI 3, 16 percentage points) more likely to receive contraception. Hypertensive Black individuals did not receive more counseling or use more contraceptives compared to non-hypertensive Black women. The lack of difference in counseling when hypertension is present is 13 percent less than the change we observed for White respondents when hypertension was present (p=0.01). The most frequently used contraceptive method among hypertensive individuals was combined oral contraceptive pills (COCs) [54.0% (95%CI 44.3-63.5%)]. ConclusionsDespite a higher likelihood of receiving contraception counseling and using contraception among hypertensive individuals at risk for unintended pregnancy, two-thirds of this population did not receive contraception counseling, and less than 40% used any contraceptive method. Furthermore, unlike for White individuals, Black individuals with hypertension did not receive more contraception care than non-hypertensive Black individuals. Of all those who used contraception, half relied on a method classified as Center for Disease Control Medical Eligibility Criteria Category 3. These findings highlight a substantial unmet need for safe and accessible contraception options for hypertensive individuals at risk for unintended pregnancy, emphasizing the importance of targeted interventions to improve contraceptive care and counseling in this population.

Effectiveness of weight-loss prevention with continual nutrition counseling in postoperative outpatients with stage IA and IB gastric cancer.

Outpatient nutritional counseling by a registered dietitian is often performed to prevent weight loss, but evidence supporting this practice is insufficient. In this study, we aimed to clarify the effectiveness of four-time outpatient nutritional counseling in weight-loss prevention compared with conventional intervention limited to one-time nutritional counseling. This study was designed as a retrospective cohort study. The target population was postoperative patients with stage IA and IB gastric cancer. Groups that received one-time and four-time nutritional counseling included patients who underwent gastrectomy from May 2014 to April 2017 and May 2017 to December 2019, respectively. The one-time group received counseling at discharge; the four-time group received counseling at discharge, at the first outpatient visit, and at 3 and 6 months postoperatively. There were 58 patients in the one-time group and 27 patients in the four-time group, with a significant difference in length of hospital stay (p = 0.042). Thirty-six patients (62.1%) in the one-time nutritional counseling group and 12 (44.4%) in the four-time group had a weight loss of 5% or more from hospital discharge to 6 months postoperatively. The adjusted risk ratio for the effectiveness of four counseling sessions compared with one session was 0.69 (95% confidence interval 0.35-1.34). In subgroup analysis, the effect of nutritional guidance was greater for patients with body mass index ≥23 kg/m2, but this depended on the outcome and number of cases, and there was no essential difference between the groups. In postoperative patients with stage IA and stage IB gastric cancer, four sessions of outpatient nutrition counseling may be not superior to one counseling session in preventing weight loss.

PERAN PENYULUHAN DALAM KEGIATAN PENCEGAHAN DAN PENGENDALIAN PENYAKIT MULUT DAN KUKU (PMK) BESERTA KENDALANYA DI KABUPATEN MOJOKERTO (The Role of Counseling in the Prevention and Control of Foot and Mouth Disease (FMD) and its Constraints in Mojokerto Regency)

Foot and Mouth Disease (FMD) in livestocks has become an epidemic in Mojokerto Regency which has caused significant economic losses, so it is necessary to carry out prevention and control. FMD prevention and control activities at the village and sub-district levels are facilitated by agricultural extension workers through Communication, Information and Education (CIE) counseling activities for breeders. This study aims to determine the role of counseling in prevention and control of FMD and the obstacles it faces. The data collection is based on online questionnaires which were distributed in 63 agriculture extension civil servants in 18 sub-districts in Mojokerto Regency. The research shows that majority of the officers have implemented CIE in all of their target areas. The counseling methods based on information technique used was direct counseling and a combination of direct and indirect counseling. The majority of counseling used printed media that contain specific materials of treatments. This study also measured the acceptance and support of stakeholders at the village level. Obstacles encountered in the field included coordination constraints, terrain and location of stables, negative issues that developed in the community and aggressive cattle conditions.

A stakeholder-developed logic model to improve utilization of pharmacy-prescribed contraception in Utah

BackgroundCurrently, 20 states in the USA have passed policies allowing pharmacists to prescribe short-acting hormonal contraception, including pills, patches, and vaginal rings. Yet, utilization of these services remains limited. The purpose of this study was to (a) assess barriers and facilitators of pharmacy contraceptive dispensing among contraceptive users, pharmacists, and healthcare providers in Utah and (b) adapt and propose an evidence-based contraceptive intervention in the pharmacy environment.MethodsWe conducted 6 focus groups among contraceptive users, pharmacists, and healthcare providers assessing current barriers and facilitators to pharmacy prescribing. We coded transcripts of these focus groups to the Consolidated Framework for Implementation Research, Version 2.0 (CFIR) and characterized the findings based on the Expert Recommendations for Implementing Change (ERIC) Barrier-Busting tool. Based on the CFIR findings and ERIC strategies output, we adapted an existing evidence-based intervention (a contraceptive access initiative) to the Utah pharmacy environment. We then convened a pharmacy stakeholder meeting and presented elements of an Implementation Research Logic Model and obtained feedback. We coded this feedback to the CFIR framework to finalize an Implementation Research Logic Model for a proposed implementation approach to improving contraceptive prescribing.ResultsInitial focus group responses clustered around specific implementation barriers including financial barriers (cost for patients, as well as lack of reimbursement for pharmacist’s time); lack of awareness of the service (on the part of patients, pharmacists, and health care providers); need for updated tools for contraceptive counseling and scheduling; and need for increased pharmacists education to conduct contraceptive counseling. Proposed adaptations to the existing contraceptive access intervention included development of a technology-based patient/pharmacist screener tool and a healthcare provider/pharmacist contraceptive referral network. Stakeholders identified pharmacist reimbursement as the top priority for improving utilization.ConclusionsElements of contraceptive access initiatives mapped well as proposed implementation strategies to improving utilization of contraceptive prescribing in pharmacies.

Equitable reach: Patient and professional recommendations for interventions to prevent perinatal depression and anxiety

ObjectivePerinatal depression and anxiety are the most common complications in the perinatal period and disproportionately affect those experiencing economic marginalization. Fewer than 15% of individuals at risk for perinatal depression are referred for preventative counseling. The goal of this study was to elicit patient and perinatal care professionals' perspectives on how to increase the reach of interventions to prevent perinatal depression and anxiety among economically marginalized individuals. MethodsWe conducted qualitative interviews with perinatal individuals with lived experience of perinatal depression and/or anxiety who were experiencing economic marginalization (n = 12) and perinatal care professionals and paraprofessionals (e.g., obstetrician/gynecologists, midwives, doulas; n = 12) serving this population. Three study team members engaged a “a coding consensus, co-occurrence, and comparison,” approach to code interviews. ResultsPerinatal individuals and professionals identified prevention intervention delivery approaches and content to facilitate equitable reach for individuals who are economically marginalized. Factors influential included availability of mental health counselors, facilitation of prevention interventions by a trusted professional, digital health options, and options for mental health intervention delivery approaches. Content that was perceived as increasing equitable intervention reach included emphasizing stigma reduction, using cultural humility and inclusive materials, and content personalization. ConclusionsLeveraging varied options for mental health intervention delivery approaches and content could reach perinatal individuals experiencing economic marginalization and address resource considerations associated with preventative interventions.

Gifted and typically developing students' friendship quality: Does empathy make a difference?

AbstractGifted students differ from their peers in cognitive, social and emotional development. This study aims to compare gifted and typically developing students in terms of friendship quality and empathy level and examine the gender differences in a sample of Turkish students. In addition, the predictive role of empathy in friendship quality among gifted and typically developing students was investigated. The sample consisted of 97 gifted and 135 typically developing primary and secondary school students. Data were analysed by two‐way analysis of variance and regression analysis. Results revealed that friendship quality was predicted by cognitive empathy in gifted and typically developing students. In addition, some gender differences emerged. The results are discussed in terms of the skills that need to be supported with preventive psychological counselling.

Reproductive care in community health centers: Multi-method evaluation of the Illinois Contraceptive Access Now (ICAN!) demonstration program

ObjectivesNearly one-third of low-income women of reproductive age in the U.S. receive care in federally qualified community health centers, but comprehensive reproductive care is not consistently provided. Illinois Contraceptive Access Now (ICAN!) is an initiative addressing the access gap to high-quality contraceptive care with a focus on normalizing reproductive health screening for patients in federally qualified community health centers (FQHCs). Study designThis multi-method program evaluation used the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, with retrospective and prospective data collection from three Illinois FQHCs who participated as Quality Hubs, and from a Community Advisory Board. We conducted descriptive analysis of patient surveys using the Person-Centered Contraceptive Counseling (PCCC) measure (n = 142); clinician and staff pre-and post-training surveys (n = 210); and Community Advisory Board surveys (n = 8) collecting quantitative and qualitative feedback. We ran logistic regression on claims data from 15- to 49-year-old patients identified as female at birth (n = 103,756). ResultsReach assessment showed patients receiving contraceptive or preconception care increased from 1063 per month in 2020 to 1236 per month in 2021 (16% increase), while general volume increased 2%. Effectiveness showed most patients (78%) described the quality of contraceptive counseling as “excellent” on the PCCC. Adoption assessment showed knowledge increases after clinical training on Modern Contraception (85% pre-training, 95% post-training) and Reproductive Justice (RJ) (58% pre-training, 70% post-training). Implementation assessment found that most Community Advisory Board members felt ICAN! was responsive to community needs. ConclusionsThe ICAN! demonstration year increased provider knowledge and volume of reproductive care at three Illinois FQHCs. ImplicationsContraceptive access initiatives that operationalize same day access to birth control methods while training FQHC providers on RJ and modern contraception, show promise on several measures. Early evidence from ICAN! indicates increased reproductive health service provision, as well as increases in provider knowledge of RJ and modern contraceptive care.

Popular contraception videos on TikTok: An assessment of content topics

ObjectivesThis study aimed to explore the contraception content topics on the highly popular social media platform TikTok to understand this influential information source patients may bring into birth control counseling visits. Study designUtilizing a snapshot method, we collected the 100 most popular TikTok English-language videos for each of the eight contraception-specific search terms. We abstracted video content topics addressed and creator attributes. Two independent abstractors coded each video with high agreement, with a third coder adjudicating discrepancies. ResultsThe final data set included 700 unique videos, with a total of 1.18 billion views, 131 million likes, 1.5 million comments, and 4.1 million shares. In these videos, the most common topics addressed were patient experience (n = 365, 52.1%) and logistics of use (n = 351, 50.1%). Health care professionals created only 19.3% of videos (n = 135), but these videos accounted for a larger portion of the total video views (41.3%). Health care professionals largely made educational videos (92.6%) compared to 22.5% of videos coded as educational videos when made by perceived non–health care professionals. A small number of prolific video creators developed the majority of videos made by health care professionals, with 91 (67.4%) made by six TikTok creators. ConclusionsTikTok contains highly accessible contraception content, which garners high viewership, especially when created by health care providers. Clinicians should be aware of TikTok’s potential to influence patients prior to contraceptive counseling visits and recognize this platform as a public health instrument to disseminate contraceptive information to a key demographic. ImplicationsFew previous studies have examined the presence and popularity of contraception content topics on TikTok; little is known about the health content on this highly popular platform. Providers should be aware of the contraceptive topics on TikTok for understanding both patient perceptions and the potential for health education through this media.

Evaluating the Acceptability and Feasibility of a Sexual Health-Focused Contraceptive Decision Aid for Diverse Young Adults: User-Centered Usability Study.

Young adults with low sexual health literacy levels may find it difficult to make informed decisions about contraceptive methods. We developed and pilot-tested a web-based decision aid-Healthy Sex Choices-designed to support diverse young adults with their contraceptive decision-making. This pilot study aimed to evaluate whether the Healthy Sex Choices decision aid is acceptable and feasible to patients and clinicians. We used the Ottawa Decision Support Framework and the International Patient Decision Aid Standards to develop and pilot the decision tool. We first conducted a needs assessment with our advisory panel (5 clinicians and 2 patients) that informed decision aid development. All panelists participated in semistructured interviews about their experience with contraceptive counseling. Clinicians also completed a focus group session centered around the development of sex education content for the tool. Before commencing the pilot study, 5 participants from ResearchMatch (Vanderbilt University Medical Center) assessed the tool and suggested improvements. Participants were satisfied with the tool, rating the acceptability as "good." Interviewees revealed that the tool made contraceptive decision-making easier and would recommend the tool to a family member or friend. Participants had a nonsignificant change in knowledge scores (53% before vs 45% after; P=.99). Overall, decisional conflict scores significantly decreased (16.1 before vs 2.8 after; P<.001) with the informed subscale (patients feeling more informed) having the greatest decline (23.1 vs 4.7; mean difference 19.0, SD 27.1). Subanalyses of contraceptive knowledge and decisional conflict illustrated that participants of color had lower knowledge scores (48% vs 55%) and higher decisional conflict (20.0 vs 14.5) at baseline than their white counterparts. Participants found Healthy Sex Choices to be acceptable and reported reduced decisional conflict after using the tool. The development and pilot phases of this study provided a foundation for creating reproductive health decision aids that acknowledge and provide guidance for diverse patient populations.

Community-engaged optimization of COVID-19 rapid evaluation and testing experiences: roll-out implementation optimization trial

BackgroundThere continues to be a need for COVID-19 testing that is pragmatic, community-centered, and sustainable. This study will refine and test implementation strategies prioritized by community partners: (1) walk-up no-cost testing, (2) community health worker (promotores)-facilitated testing and preventive care counseling, (3) vending machines that dispense no-cost, self-testing kits.MethodsA co-designed Theory of Change from an earlier study phase and the Practical, Robust Implementation and Sustainment Model (PRISM) will guide the study design, measures selection, and evaluation. The first aim is to refine and operationalize a multi-component implementation strategy bundle and outcome measures for COVID-19 testing. A Community and Scientific Advisory Board (CSAB) will be established and include community members, clinical providers/staff from the partnering Federally Qualified Health Center (FQHC), public health researchers, policymakers, and a county health department ambassador. Engagement of CSAB members will be assessed through structured ethnography and a survey about the quality and quantity of engagement practices. The second aim is to implement and evaluate the impact of the implementation strategy bundle to optimize COVID-19 testing in communities using a roll-out implementation optimization (ROIO) design. Seven thousand and five hundred community members will be enrolled across four FQHC clinics over 18 months. Participants will be invited to complete an electronic survey about their demographics, health, and COVID-19 testing results and experiences. CSAB members and clinic partners will participate in PRISM fit and determinant assessments prior to each clinic rollout and post-trial. Interviews will be conducted with 60 community participants and 12 providers/staff following a 3-month rollout period at each clinic, inquiring about their experiences with the implementation strategies. Quantitative data will be analyzed using hierarchical multilevel models to determine the impact of implementation strategies. Qualitative data will be analyzed using rapid qualitative approaches to summarize implementation experiences and identify necessary changes prior to subsequent rollouts. A matrix approach will be used to triangulate data from quantitative and qualitative sources based on PRISM domains.DiscussionThis is one of the first pragmatic implementation trials to use a ROIO design and aims to co-create a sustainable and equitable COVID-19 testing program. Findings are likely to generalize to other public health prevention efforts.Trial registrationNCT05894655 March 2, 2023.

Use of Contraceptive Methods Among Women in the General Population and Female Gynecologists in Spain: the ELEGIAN Survey.

The contraceptive preferences of obstetricians and gynecologists (OB/GYNs) are thought to influence the contraceptive counseling they provide. The purpose of this study was to assess contraceptive preferences of OB/GYNs and women in the general population (WGP) in the current Spanish contraceptive scenario. Anonymous online survey of 100 OB/GYNs and 1,217 WGP aged 23-49 years. WGP were younger (35.3 ± 7.3 vs. 37.9 ± 6.2 years, respectively) and less likely to have stable partners (64.7% vs. 84.0%) and children (49.1% vs. 62.0%) (all p < 0.05 vs. OB/GYNs). Seventy-nine percent versus 82%, respectively, used contraceptive methods, with condoms used most frequently by WGP (37% vs. 22% by OB/GYNs; p < 0.05) and pills by OB/GYNs (26% vs. 21% by WGP; p > 0.05). Intrauterine devices (IUDs) were more frequently used by OB/GYNs (20% vs. 5%; p < 0.05), especially the levonorgestrel-releasing intrauterine devices (LNG-IUDs) (18% vs. 2.6%; p < 0.05). The highest-rated methods were condoms among WGP and LNG-IUDs among OB/GYNs. Effectiveness was the most valued attribute of contraceptive methods for both. Reasons related to convenience were the main reason for choosing IUDs. OB/GYNs prescribed the contraceptive method in 40% of cases. Our study reveals differences between female OB/GYNs and WGP in contraceptive methods use and rating. The use of LNG-IUDs was much higher among OB/GYNs.

Long-acting family planning switching and associated factors among revisit women in Toke Kutaye district of West Shoa Zone, Oromia Region public health facilities, Ethiopia: a mixed methods study

BackgroundSwitching from a long-acting family planning (LAFP) method to another could lead to an unintended pregnancy. However, the proportions of LAFP method switching and predictable factors are not well addressed. Therefore, the aim of this study was to determine the magnitude of LAFP method switching and associated factors among revisit women. The study also explored the reasons for the LAFP method switching among the revisited women.MethodA mixed methods study was conducted among 377 reproductive age women attending public health facilities in Toke Kutaye district, West Shoa, Zone, Ethiopia, from 20 May 2021 to 28 July 2021. A systematic random sampling for quantitative and purposive sampling technique for qualitative study was used to select the study participants. A pretested structured questionnaire and in-depth interview were used to determine and explore long-acting family planning switching among revisit women. Data were analysed by Statistical Package for the Social Sciences (SPSS) version 21. Binary logistic regression was conducted to identify the dependent and independent variables at p-value < 0.05 along with 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR). The qualitative data were analysed using thematic analysis.ResultsThe magnitude of long-acting family planning method switching was 53.3%. Switching from an implant to other short-acting method was 39.8%, and switching from an intrauterine contraceptive device (IUCD) to other short-acting method was 13.5%. A formal education (AOR, 10.38, 95% CI: 3.48, 30.95), birth spacing (AOR, 5.52, 95% CI: 1.31, 23.33) and perceived infertility (AOR, 11.16, 95% CI: 5.55, 22.45) were factors associated with LAFP switching. The qualitative findings revealed that fear of side effects, lack of adequate information, religion, and misconceptions hinder users from maintaining the LAFP.ConclusionsThe study finds that the proportion of women switching from long-acting family planning was relatively higher than in other studies. The main reasons for LAFP switching were fear of side effects, lack of adequate information specific to LAFP and misconceptions. Therefore, the provision of quality contraceptive counselling by the service providers may mitigate the concern of IUD and implant switching. Furthermore, future prospective research at a larger sample size is needed.

Contraception, pregnancy, and STI counseling and care among transitioning young adults with sickle cell disease

Contraception, pregnancy, and STI counseling and care among transitioning young adults with sickle cell disease

Gestational trophoblastic neoplasia: does centralization of care impact clinical management?

ObjectiveInternational societies advocate for gestational trophoblastic neoplasia referral to designated expert centers. This study assessed the impact of centralization of trophoblastic care on clinical outcomes.MethodsA centralized program was implemented in...