DISCLOSURE PATTERNS OF FEMALE ADOLESCENTS ACCESSING LONG-ACTING REVERSIBLE CONTRACEPTION AT URBAN SCHOOL-BASED HEALTH CENTERS

Purpose: Studies have shown that greater communication by female adolescents with parents and friends about sexual relationships is associated with increased contraceptive use. However, little is known about disclosure patterns for young women choosing to initiate Long-Acting Reversible Contraceptio...

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Bibliographic Details
Published in:Journal of adolescent health 2019-02, Vol.64 (2S), p.S119
Main Authors: Mark, Gabriella Schlüssel, Hoffman, Neal D, Silver, Ellen
Format: Article
Language:English
Subjects:
Adolescent girls
Adolescent sexuality
Birth control
Chart reviews
Childbirth & labor
Contraceptives
Counseling
Females
Friendship
Health facilities
Health insurance
Intrauterine devices
IUD
Latin American cultural groups
Medicaid
Personal characteristics
Reversible
Secondary schools
Sexual behavior
Teenagers
Urban schools
Women
Young women
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Summary:Purpose: Studies have shown that greater communication by female adolescents with parents and friends about sexual relationships is associated with increased contraceptive use. However, little is known about disclosure patterns for young women choosing to initiate Long-Acting Reversible Contraception (LARC). Methods: We completed a retrospective chart review of female adolescents who accessed Implant or Intrauterine Device (IUD) services at a network of school-based health centers at 13 high school campuses in the Bronx, New York, between November 2015 and December 2017. Demographic data, previous hormonal contraception and pregnancy history were obtained from a standard data report form completed at the time of each LARC insertion encounter. Data about disclosure patterns were obtained from review of a structured Adolescent Sexuality flow sheet within the electronic health record for each LARC insertion encounter; if the field was incomplete, the provider's note was reviewed for documentation of disclosure. Chi-square analyses were used to examine differences between the two LARC groups in their personal characteristics and disclosure patterns. Results: Of the 518 female adolescents ages 13-21 years who had a LARC insertion procedure during the time period, 68.5% chose an Implant and 31.5% chose an IUD. Their mean age was 16.5 years (SD 1.3). 75.1 % identified as Hispanic/Latina and 18.3% as Black. 56.4% had Medicaid health insurance and 30.7% had no or unknown health insurance. There were no differences by LARC type. 8.1% reported having ever been pregnant and 3.7% reported having ever given birth, with a higher percentage among those choosing an Implant (4.8%) compared to those choosing an IUD (1.2%) (p=0.045). A lower percentage of those who chose an Implant (43.7%) compared to an IUD (63.2%) reported previously using hormonal contraception (p
ISSN:1054-139X
1879-1972