Provision Of Counseling Research Articles

Kegiatan Pemberdayaan Masyarakat di Wilayah Madewangi RW 02 Kelurahan Setiamulya Kecamatan Tamansari Kota Tasikmalaya dengan Melakukan Penyuluhan dan Pemeriksaan Kesehatan

Hypertension is one of the main health problems faced by people around the world, including Indonesia. Hypertension is known as a "silent killer" because it often does not show symptoms until it reaches a serious stage. At the Tamansari Health Center in Tasikmalaya City, hypertension is the highest disease most suffered by the community with a total of 586 cases from January to October 2024. The high prevalence of hypertension in the Tamansari Health Center work area, a prevention and control program is needed through screening or early detection programs and counseling about hypertension. The implementation method carried out in this community service is to provide information using the lecture or counseling method. To measure public knowledge, pre-test and post-test are carried out. In addition to providing counseling, this activity also provides basic health checks. Based on the results obtained, there was a difference in the level of community knowledge before and after the provision of counseling which can be seen from the difference in the average percentage of pre-test and post-test.

Polygenic risk scores in the clinic: a systematic review of stakeholders' perspectives, attitudes, and experiences.

Polygenic Risk Scores (PRS) are statistical methods estimating part of an individual's genetic susceptibility to various disease phenotypes. Their potential clinical applications to enhance the prediction, prevention, and risk management of complex conditions motivate current research efforts worldwide. While a growing body of literature has highlighted the scientific and ethical limitations of PRS, the technology's clinical translation will present both opportunities and challenges for the stakeholders involved. Here, a mixed-method systematic review of empirical studies was performed to gather evidence on the perspectives, attitudes, and experiences of healthcare providers, patients, and the public regarding the use of PRS in healthcare settings. The PRISMA reporting protocol was followed and 24 articles were included. Three major themes were identified. First, we reported on participants' familiarity with the test, including their knowledge, understanding, and education on PRS' clinical use. The second theme collects stakeholders' motivations for taking the test and their perspectives on sensitive issues related to the return of results. Participants' normative stances regarding the appropriate use of PRS, their benefits, and harms were presented in the third theme. The findings underscore significant knowledge gaps and challenges in the clinical interpretation of PRS among healthcare providers. On the other hand, the provision of genetic counseling benefitted patients' understanding of PRS results and in most cases, no psychosocial burden was reported. Finally, the review highlights that stakeholders' perspectives on the clinical use of PRS are highly context-dependent, shaped by population characteristics, disease type, and social factors, emphasizing the need for tailored approaches across diverse healthcare settings.

Metabolic syndrome among patients with type 2 diabetes in Jordan: A cross-sectional study.

Metabolic syndrome is a major public health problem worldwide and an independent predictor of cardiovascular disease in patients with type 2 diabetes (T2DM). This study aimed to determine the prevalence of metabolic syndrome and its individual components among Jordanian patients with T2DM. A cross-sectional design was conducted among T2DM patients at the National Center for Diabetes, Endocrinology and Genetics in Jordan. Data were collected using a structured questionnaire and clinical data extracted from medical records. The National Cholesterol Education Program-Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) diagnostic criteria were used to define metabolic syndrome. Among 1017 participants aged between 22 and 90 years, the overall prevalence of IDF defined metabolic syndrome was 84.2% (72.5% and 96.2% among males and females, respectively). Using ATP III criteria, overall prevalence was 79.1% (77.4% and 80.8% among males and females, respectively). Advancing age, female gender, nonadherence to a diet regimen, sedentary lifestyle or insufficient physical activity, and duration of diabetes ≥10 years were significantly associated with increased odds of metabolic syndrome, regardless of the definition used. Current smoking status and family history of cardiovascular diseases were significantly associated with increased likelihood of ATP III defined metabolic syndrome. The prevalence of metabolic syndrome among Jordanian patients with T2DM is extremely high. The main modifiable risk factors of metabolic syndrome among these patients include nonadherence to a diet regimen, insufficient physical activity, being overweight/obese and smoking. It is recommended that healthcare providers counsel patients on the importance of maintaining physical activity, smoking cessation, and adherence to a diet regimen.

Risky Sexual Behavior in Men Who Have Sex with Men at Sentani Public Health Center

Men Who Have Sex with Men (MSM) is used for men who engage in sexual activities with other men who are increasingly online to show their true selves. Men who have sex with men (MSM) have a higher risk of contracting sexually transmitted infections, especially being infected with the Human Immunodeficiency Virus (HIV). The purpose of this study was to determine the risky sexual behavior of men who have sex with men at the Sentani Papua Health Center. The research method used a qualitative approach with in-depth interviews. Determination of informants using purposive sampling technique with a total of 4 informants (3 main informants and 1 key informant). Data were collected through in-depth interviews and then analyzed thematically. Results: the results of this study indicate that informants are aged 18-35 years, and produce five (5) themes, namely sexual orientation where all informants are attracted to the same sex (homosexual), no sexual disorientation, sexual deviations obtained from informants are never using condoms, having anal sex, having oral sex, and ejaculating in the mouth, and opportunistic diseases found in informants are Gonorrhea, Candidias, Diarrhea, TB, Dermatitis, and TB. Lungs Conclusion: the results of the study indicate that all informants who like the same sex, engage in sexually deviant behavior every time they engage in sexual activity and informants need the provision of hotline counseling in preventing HIV transmission.

Client Perspectives on Contraceptive Care: A Systematic Review.

Contraceptive care is an opportunity for providers to help clients achieve their reproductive health goals. Client-centeredness is a core element of quality care; however, evidence suggests that the provision of client-centered contraceptive counseling needs improvement. This systematic review summarizes recent evidence on client preferences related to contraceptive care, including how client-centered approaches inform outcomes. A systematic review was conducted in PubMed, Cochrane Database of Systematic Reviews, and Scopus to identify articles published between December 1, 2016 and May 1, 2023. Studies that explored client preferences related to contraceptive counseling, education, and/or care, and how client-centered approaches impact clients' perceived experiences with their care were included. Thirty-nine unique studies met inclusion criteria. Clients want a range of information about contraceptive methods tailored to their preferences through a variety of formats, before, during, and after their appointment. Clients desired providers with similar demographic backgrounds (gender, race, ethnicity) and life experiences (menstruation, contraceptive use, carceral system encounters) to themselves, and who are willing to offer continuous care. Clients reported greater satisfaction when providers engaged in shared decision-making, utilized decision support tools, and supported their autonomy, including prioritizing their family-building goals. When providers shared personal preferences or pressured clients to select one method over another, clients in turn, reported feeling conflicted about which method to select and some subsequently declined using any method. The variation in client preferences highlight the importance of offering tailored, comprehensive information that supports decision-making, prioritizes client autonomy, and recognizes positive interpersonal relationships with providers. Prospero: CRD42023414456 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=414456.

Overview of Integrated Antenatal Care (ANC) Implementation in the Regional Technical Implementation Unit West Selemadeg Health Center Tabanan Regency

Providing comprehensive and quality ANC services to pregnant women is called Integrated ANC services. The indicator used to describe pregnant women's access to antenatal care is K1 coverage while the indicator to describe service quality is K4-K6 coverage with 10T service quality including physical examination, laboratory examination, provision of fe table, immunization and counseling. The purpose of the study was to determine the description of the application of integrated antenatal care (ANC) in the Regional Technical Implementation Unit of the West Selemadeg Health Center. This type of research is descriptive quantitative. Implementation of research in March - April 2024 with purposive sampling technique. The sample using the slovin formula amounted to 40 people. Data collection in the form of integrated ANC indicator data collection sheets. Data analysis using univariate in the form of frequency distribution. The results showed that pure K1, K4 and K6 visits from pure K1 were 62.5% of respondents while a small proportion of respondents according to the standards of K1 access visits, K4 and K6 from K1 access were (37.5%) respondents. The results of pure K1, K4 and K6 services from pure K1 were 62.5% of respondents while a small proportion of respondents met the standards of K1 access visits, K4 and K6 from K1 access as many as (37.5%) respondents. Suggestions for UPTD Puseksmas Selemadeg Barat to increase education to pre-conception couples and pregnant women about the purpose of visits and appropriate ANC examinations.

Supplementing provider counseling with an educational video prior to scheduled induction of labor

BackgroundInduction of labor (IOL) is common with one in four labors being induced in the United States (US). IOL has been associated with lower birth satisfaction. Video education can address gaps in education and promote anticipatory guidance. Prior studies in obstetrics have focused on randomized designs in English-speaking patients, leaving opportunities to explore how these tools perform in a pragmatic fashion with diverse patient populations. Our objective was to evaluate the effects of a video education tool on patient satisfaction and knowledge of IOL experience in English and Spanish-speaking patients scheduled for IOL at a tertiary care hospital.MethodsThis was a single site pragmatic implementation of a quality improvement measure at an academic hospital. A bilingual survey was developed to evaluate the impact of an educational video on birth satisfaction and knowledge of IOL procedures. The video is freely available in English and Spanish. Baseline postpartum surveys were collected from June to July 2021. The video was subsequently recommended by providers when scheduling IOLs. Post-intervention surveys were collected from September to November 2021 after an implementation period. Groups were compared using t-tests for satisfaction scores and chi-square analyses for categorical variables.ResultsThirty-two participants completed the baseline survey and 72 completed the post-implementation survey with response rates of 88.9% and 91.1%, respectively. There were no statistically significant changes between mean total satisfaction scores (26.9 vs 28.0 out of 40.0, p = 0.290). 61 participants were English speaking (58%) and 43 Spanish (42%). Thirty (42%) patients reported watching the video.Correct identification of amniotomy use improved in the post-intervention group (p = 0.002). No changes were seen in anticipated duration of labor nor in whether patients would choose to be induced again.ConclusionsRecommendation of video education before scheduled IOL was associated with little improvement in knowledge about IOL, but no significant improvement in patient satisfaction. While video education has improved these measures in randomized trials, our study demonstrated that real-world implementation and patient uptake may be initially difficult. This study may help providers emphasize direct education and counseling and promote optimal implementation of innovative educational media.

Maternal Medication Use in Pregnancy: A Narrative Review on Assessing and Communicating the “Risk” of Birth Defects to the Patient

The state of knowledge regarding the teratogenic effects of maternal use of medications during pregnancy is constantly evolving and is often uncertain. Timely access to high-quality information may reduce prolonged harmful exposures, decrease the number of preventable birth defects, empower patients with accurate information about the risks of exposure, and prevent unnecessary patient anxiety and pregnancy termination. In this narrative review, we describe the process by which the teratogenic risk of medications is assessed by experts in medicine, genetics, and epidemiology and how identifiable risks can be effectively communicated to patients. Risk assessment of birth defects in human pregnancy involves collecting and synthesizing available data through a proper and rule-driven evaluation of scientific literature. Expert consensus is a practical approach to determine whether a given exposure produces damage after careful consideration of gestational timing, dose and route of the exposure, maternal and fetal genetic susceptibility, as well as evidence for biological plausibility. The provision of teratogen risk counseling through appropriate interpretation of information and effective knowledge translation to the patient is critical for the prevention of birth defects and maximizing healthy pregnancies.

Parent Education and Counseling (PairEd-C) Intervention to Improve Family-Centered Care: Protocol for a Prospective Acceptability Study Using the Theoretical Framework of Acceptability.

Family-centered care (FCC) is an intervention approach based on a respectful relationship between family and health care providers (HCPs) to ensure the health and well-being of children and their families. Although HCPs have a better perception of FCC, the level of its implementation is low. Reasons for low implementation include limited understanding, lack of training, and lack of implementation guidelines and tools to support implementation. Thus, we developed the Parent Education and Counseling (PairEd-C) intervention to improve FCC in pediatric oncology settings and assess its acceptability. The objective of this study is to assess the prospective acceptability of the PairEd-C intervention using the theoretical framework of acceptability (TFA) in the pediatric oncology department in a tertiary hospital in Ethiopia. The study was conducted using an exploratory qualitative study design. We aimed to recruit 10 to 15 participants for the in-depth interview. The study participants were health service leaders working in child cancer, HCPs, social workers, and parents of children with cancer. The intervention was developed using the integration of the first phase of the Medical Research Council (MRC) framework for developing and testing complex interventions and the behavior change wheel (BCW) framework. The main PairEd-C intervention components align with the intervention functions of education, persuasion, training, environmental restructuring, modeling, and enablement, which were intended to improve FCC in the pediatric oncology unit by providing structured and comprehensive education and counseling of parents of children with cancer. The intervention was implemented by providing training for the health care team, facilitating discussion among HCPs and setting a shared plan, improving the commitment of the health care team, providing education for parents, improving parents' capacity to attend the intervention sessions, arranging discussion among parents of children with cancer, and provision of education and counseling on distress. The HCPs working in the unit received training on the designed intervention. The trained educators and the health care provider delivered the intervention. Data will be analyzed using deductive thematic coding with a framework analysis technique based on the 7 TFA constructs. Atlas ti. version 9 will be used for data analysis. Funding was acquired in 2017, and ethical clearance for conducting the study was obtained. We conducted the interviews with the study participants from December 2023 to January 2024. As of the acceptance of this protocol (June 2024), 12 study participants were interviewed. The data analysis process was started subsequently, and the manuscript will be completed and submitted for publication in early 2025. This acceptability study is expected to show that the designed intervention is acceptable to study participants, and the findings will be used to improve the intervention before progressing to the next step of our project. DERR1-10.2196/54914.

Resilience Development Among Adult Patients With DeNovo Acute Leukemia: A Qualitative Study.

This study aimed to explore the development process of psychological resilience among adult patients with de novo acute leukemia. This study utilized a descriptive qualitative approach, employing a purposeful sampling method to select a sample of 15 newly diagnosed patients with acute leukemia (AL) who underwent their initial induction chemotherapy treatment at the Hematology Department of the First Affiliated Hospital of Zhejiang University School of Medicine, China. Semi-structured interviews were conducted with the selected patients. Content analysis methodology was used to analyze, summarize, and extract themes from the collected data. Three categories emerged-namely, (1) negative period, (2) adaptive response phase, and (3) growth transformation period. The negative period occurs during the initial diagnosis and throughout the treatment cycle. However, influenced by both internal and external protective factors, including personal characteristics and social support, individuals enhance their psychological resilience through emotional regulation, mental adjustment, and adaptive strategies vis-à-vis healthcare decision-making and disease management. Overall, psychological resilience development follows an upward spiral trajectory. This study identified that negative emotions and symptom clusters impede the development of patients' psychological resilience. Moreover, it revealed a substantial need for disease-related information among patients. Therefore, healthcare professionals should prioritize addressing the negative emotions of patients, early identification of protective factors, dynamic monitoring of symptom clusters, effective management, and provision of psychological counseling and interventions. Simultaneously, providing personalized, professional, and systematic disease-related information is vital for promoting psychological resilience development.

Oral Contraceptives: Analyzing Effectiveness and Utilization Challenges to Improve Reproductive Health Outcomes

Background: Oral contraceptives (OCs) are widely used for preventing unintended pregnancies and offering various reproductive health benefits. However, their utilization is influenced by numerous factors, including access, education, and cultural beliefs. This meta-analysis aims to systematically review studies from 2019 to 2023 focusing on OC utilization patterns and effectiveness. Methods: A comprehensive search across PubMed, Scopus, and Google Scholar identified 50 relevant articles, from which nine studies were selected based on predefined criteria. Data extraction included demographic factors, adherence rates, side effects, access to OCs, and pregnancy outcomes. Quality assessments were performed using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool, followed by statistical analysis using random-effects models. Results: The analysis revealed a pregnancy rate as low as 0.3% among perfect OC users, showcasing their high effectiveness. However, significant barriers persist, including poor adherence, discontinuation due to side effects, and disparities in access, particularly in low-income regions. Cultural perceptions and insufficient education further hinder optimal OC utilization. Conclusion: While OCs represent a reliable contraceptive method with substantial health benefits, ongoing challenges impede their optimal use. A multifaceted approach focusing on improved education, enhanced healthcare provider counseling, and targeted access initiatives is essential to increase OC utilization and reproductive health outcomes globally. Addressing these challenges will empower individuals to make informed family planning decisions, ultimately reducing unintended pregnancies and enhancing quality of life.

Exploring Diagnostic and Therapeutic Odyssey in Pulmonary Arterial Hypertension: Insights from In-Depth Semi-Structured Interviews

Introduction: Establishing a diagnosis is paramount in medical practice as it shapes patients’ experiences and guides treatment. Patients grappling with rare diseases face a triple challenge: prolonged diagnostic journeys, limited responses to existing therapies, and the absence of effective monitoring tools. Genetic diagnosis often provides crucial diagnostic and prognostic information, opening up possibilities for genotype-targeted treatments and facilitating counselling and relative testing. The NIHR BioResource – Rare Diseases (NBR) Study and the Cohort Study in Idiopathic and Hereditary Pulmonary Arterial Hypertension (PAH Cohort study) aimed to enhance diagnosis and treatment for PAH, successfully identifying the genetic cause in 25% of idiopathic cases. However, the diagnostic and therapeutic odyssey in patients with PAH remains largely unexplored. Methods: Stakeholders from the NBR and PAH Cohort studies were recruited using purposive sampling. In-depth interviews and focus groups were recorded, transcribed, anonymised, and analysed thematically using MAXQDA software. Results: The study involved 53 interviews and focus groups with 63 participants, revealing key themes across five stages of the diagnostic odyssey: initial health concerns and interactions with general practitioners, experiences of misdiagnosis, relief upon receiving the correct diagnosis, and mixed emotions regarding genetic results and the challenges of living with the disease. Following the diagnosis, participants embarked on a therapeutic journey, facing various challenges, including the disease’s impact on professional and social lives, the learning curve associated with understanding the disease, shifts in communication dynamics with healthcare providers, therapeutic hurdles, and insurance-related issues. Building on these insights, we identified areas of unmet needs, such as improved collaboration with primary care providers and local hospitals, the provision of psychological support and counselling, and the necessity for ongoing patient education in the ever-evolving realms of research and therapy. Conclusions: The study highlights the significant challenges encountered throughout the diagnostic and therapeutic journey in PAH. To enhance patient outcomes, it is crucial to raise awareness of the disease, establish clear diagnostic pathways, and seamlessly integrate genetic diagnostics into clinical practice. Streamlining the diagnostic process can be achieved by utilising existing clinical infrastructure to support research and fostering better communication within the NHS. Moreover, there is an urgent need for more effective therapies alongside less burdensome drug delivery methods.

Bariatric Surgery Underutilization in Young Postadolescent Population With Obesity

PurposeBariatric surgery is an established treatment option for adolescent patients struggling with obesity, yet it remains underutilized. We aimed to gain insight into patients’ views of bariatric surgery and identify the strategies for improved utilization of the procedure in early postadolescence. MethodsThe electronic medical records of patients diagnosed with obesity at a tertiary medical center, ages 18–22 years old, were examined. Patients participated in a follow-up survey related to obesity treatment. FindingsWhile 20% of patients had BMIs ≥ 35 kg/m2 in adolescence, more than half (54%) of patients with obesity reached BMIs ≥ 35 kg/m2 after 18 y/o, thus potentially qualifying for bariatric surgery. A minority of patients (6/280, 2%) underwent bariatric surgery and experienced substantial weight loss in early postadolescence. Most remaining surgery-eligible patients (141/152, 93%) noted a BMI increase (0.05–28.6 kg/m2) during the immediate young adult study period without surgical intervention. While 66.7% of patients who recall receiving surgery-specific counseling would consider surgery as a part of their treatment, only 4.6% of patients who did not recall counseling would consider undergoing bariatric surgery. ImplicationsIn the absence of provider referral during adolescence, bariatric surgery remains underutilized in early postadolescence. Provider counseling is an essential component of patients’ willingness to consider bariatric surgery.

Exploring primary care physician biases in adolescent contraceptive counseling

Objective(s)While previous literature has shown clinician bias in adult contraceptive counseling, less is known on the biases clinicians may exhibit when counseling adolescents about contraception. Our study aimed to describe long-acting reversible contraception (LARC) counseling and prescribing practices of adolescent-serving clinicians. Study designThis study used a cross-sectional discrete choice experiment mixed methods design. We sent a survey containing vignettes and items pertaining to demographics and beliefs to a convenience sample of adolescent-serving clinicians across the United States. ResultsOf 296 clinicians, 80% were in pediatrics, and had geographic, practice setting, gender, and racial diversity. Most clinicians reported being up-to-date with current literature regarding contraception. Sixty-eight percent of respondent’s practices administer contraceptive injections, but only 17% place intrauterine devices (IUDs). Of those who do insert IUDs, nearly half inserted five or fewer within the last year. Patients’ younger age and Hispanic ethnicity were associated with lower odds, and history of pregnancy was associated with higher odds, of clinicians’ recommending LARC. Across all vignettes, the top five reasons clinicians chose their first-choice method for the patient were adherence or compliance, efficacy, side effects, patient age, and reversibility. Conclusion(s)Clinicians often recommend contraceptives based on adherence, efficacy, and age, and we found younger age, minoritized race or ethnicity, and history of pregnancy were all associated with LARC recommendations, indicating potential biases against teen parents and assumptions about adolescents’ priorities. This may impede the provision of patient-centered contraceptive counseling for adolescents, and highlights the need for improved education and practice changes post-Dobbs. ImplicationsWe found that clinicians demonstrated several biases in how they provide contraceptive recommendations to adolescent patients. These biases were often associated with their personal beliefs and experiences. Our findings can guide the development of future interventions aimed at improving adolescent reproductive health counseling and care delivery in primary care settings.

Genetics Navigator: protocol for a mixed methods randomized controlled trial evaluating a digital platform to deliver genomic services in Canadian pediatric and adult populations

IntroductionGenetic testing is used across medical disciplines leading to unprecedented demand for genetic services. This has resulted in excessive waitlists and unsustainable pressure on the standard model of genetic healthcare....

A Phenomenological Study on Vicarious Trauma Experienced by Social Workers Who Provide Counseling Services to Suicide Bereaved Families

A Phenomenological Study on Vicarious Trauma Experienced by Social Workers Who Provide Counseling Services to Suicide Bereaved Families

Influence of smoking, nutrition and other modifiable environmental factors on rheumatoid arthritis

Numerous reports in recent years have focused on the influence of environmental factors on rheumatoid arthritis. This article provides an overview of the current study situation on the influence of modifiable environmental factors on the development and course of rheumatoid arthritis. Lifestyle factors, such as cigarette smoking, diet, exercise and body weight can be individually influenced. Factors such as air pollution and socioeconomic status can be influenced by environmental and sociopolitical measures at apublic level. Epidemiological studies have identified nicotine abuse, an unhealthy diet and obesity as well as alow level of education and social status as risk factors for the development of rheumatoid arthritis. Numerous factors are also associated with apoorer response to treatment and aworse prognosis. As randomized interventional studies on most environmental factors are hardly feasible, the causal relationship of the individual factors to the incidence and progression of rheumatoid arthritis is difficult to quantify. Nevertheless, the current evidence already enables the provision of appropriate counselling to patients with rheumatoid arthritis with respect to ahealthy lifestyle including abstaining from cigarette smoking, maintaining ahealthy diet, physical activity and avoiding obesity.

Should the scope of NIPT be limited by a 'threshold of seriousness'?

Non-invasive prenatal testing (NIPT) has the potential to screen for a wider range of genetic conditions than is currently possible at an early stage of pregnancy and with minimal risks. As such, there have been calls to apply a 'threshold of seriousness' to limit the scope of conditions being tested. This approach is based on concerns about society at large and the potential impact on specific groups within it. In this paper, we argue that limiting the scope of NIPT using the criterion of 'seriousness' is arbitrary, potentially stigmatises certain disabilities over others and fails to respect reproductive autonomy. We contend that concerns about expanded NIPT are more appropriately addressed by the provision of adequate information, counselling and consent procedures. We recommend a decision-making process that helps healthcare providers support prospective parents to make informed decisions about the nature and scope of NIPT screening based on their own values and social context. In addition to addressing concerns about expanded NIPT screening, this process would help clinicians to obtain legally valid consent and discharge their duty of care (including the duty to inform) in the prenatal context.

U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.

The 2024 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) comprises recommendations for the use of specific contraceptive methods by persons who have certain characteristics or medical conditions. These recommendations for health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta, Georgia, during January 25-27, 2023. The information in this report replaces the 2016 U.S. MEC (CDC. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR 2016:65[No. RR-3]:1-103). Notable updates include 1) the addition of recommendations for persons with chronic kidney disease; 2) revisions to the recommendations for persons with certain characteristics or medical conditions (i.e., breastfeeding, postpartum, postabortion, obesity, surgery, deep venous thrombosis or pulmonary embolism with or without anticoagulant therapy, thrombophilia, superficial venous thrombosis, valvular heart disease, peripartum cardiomyopathy, systemic lupus erythematosus, high risk for HIV infection, cirrhosis, liver tumor, sickle cell disease, solid organ transplantation, and drug interactions with antiretrovirals used for prevention or treatment of HIV infection); and 3) inclusion of new contraceptive methods, including new doses or formulations of combined oral contraceptives, contraceptive patches, vaginal rings, progestin-only pills, levonorgestrel intrauterine devices, and vaginal pH modulator. The recommendations in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care providers about contraceptive use.

U.S. Selected Practice Recommendations for Contraceptive Use, 2024.

The 2024 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a selected group of common, yet sometimes complex, issues regarding initiation and use of specific contraceptive methods. These recommendations for health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta, Georgia, during January 25-27, 2023. The information in this report replaces the 2016 U.S. SPR (CDC. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR 2016;65[No. RR-4]:1-66). Notable updates include 1) updated recommendations for provision of medications for intrauterine device placement, 2) updated recommendations for bleeding irregularities during implant use, 3) new recommendations for testosterone use and risk for pregnancy, and 4) new recommendations for self-administration of injectable contraception. The recommendations in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care providers about contraceptive use.