Jenny Francis1, Liandra Presser2, Katherine Malbon3, Debra Braun-Courville4, Lourdes Oriana Linares2. 1. Department of Pediatrics, Division of Child and Adolescent Health, Columbia University Medical Center, New York, NY 10032, USA. Electronic address: jf2815@cumc.columbia.edu. 2. Department of Pediatrics, Division of Adolescent Medicine, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA. 3. Tribeca Pediatrics, Adolescent Medicine Specialist, New York, NY 10007, USA. 4. Department of Pediatrics, Division of Adolescent Medicine. Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Abstract
OBJECTIVE: We examine the association between depressive symptoms and contraceptive method choice among adolescents initiating prescription contraception. STUDY DESIGN: This cross-sectional study analyzes baseline data of 220 urban, minority adolescent females (ages 15-19 years) presenting for prescription contraceptive initiation at a comprehensive, free-of-cost, adolescent health center in New York City. All participants met with a health care provider who provided standard contraception counseling before initiating contraception. Each participant then selected a short- or long-acting contraceptive: a 3-month supply of the pill, patch, ring or a medroxyprogesterone acetate depot injection (short-acting), or placement/referral for an intrauterine device (IUD; long-acting). We assess the independent association between contraceptive method selection and symptoms of depression [assessed by the Center for Epidemiological Studies - Depression (CES-D) scale]. RESULTS: Ten percent (n=21/220) of adolescent females selected an IUD. Bivariate analysis revealed that those with elevated levels of depressive symptoms were more likely to select an IUD as compared to those with minimal symptoms (mean CES-D score 20 vs. 13; t=3.052, p=.003). In multivariate logistic regressions, adolescent females had increased odds of selecting an IUD if they reported moderate to severe depressive symptoms (adjusted odds ratio=4.93; confidence interval, 1.53-15.83; p=.007) after controlling for ethnicity/race, education, number of lifetime partners and gravidity. CONCLUSIONS: Inner-city, minority adolescents with elevated symptoms of depression who present for prescription contraceptive initiation may be more likely to select an IUD rather than shorter-acting methods. By recognizing adolescent females with depressive symptoms, providers can strategize their approach to effective contraception counseling.
OBJECTIVE: We examine the association between depressive symptoms and contraceptive method choice among adolescents initiating prescription contraception. STUDY DESIGN: This cross-sectional study analyzes baseline data of 220 urban, minority adolescent females (ages 15-19 years) presenting for prescription contraceptive initiation at a comprehensive, free-of-cost, adolescent health center in New York City. All participants met with a health care provider who provided standard contraception counseling before initiating contraception. Each participant then selected a short- or long-acting contraceptive: a 3-month supply of the pill, patch, ring or a medroxyprogesterone acetate depot injection (short-acting), or placement/referral for an intrauterine device (IUD; long-acting). We assess the independent association between contraceptive method selection and symptoms of depression [assessed by the Center for Epidemiological Studies - Depression (CES-D) scale]. RESULTS: Ten percent (n=21/220) of adolescent females selected an IUD. Bivariate analysis revealed that those with elevated levels of depressive symptoms were more likely to select an IUD as compared to those with minimal symptoms (mean CES-D score 20 vs. 13; t=3.052, p=.003). In multivariate logistic regressions, adolescent females had increased odds of selecting an IUD if they reported moderate to severe depressive symptoms (adjusted odds ratio=4.93; confidence interval, 1.53-15.83; p=.007) after controlling for ethnicity/race, education, number of lifetime partners and gravidity. CONCLUSIONS: Inner-city, minority adolescents with elevated symptoms of depression who present for prescription contraceptive initiation may be more likely to select an IUD rather than shorter-acting methods. By recognizing adolescent females with depressive symptoms, providers can strategize their approach to effective contraception counseling.
Authors: Julia R Steinberg; Nancy E Adler; Kirsten M Thompson; Carolyn Westhoff; Cynthia C Harper Journal: Soc Sci Med Date: 2018-08-13 Impact factor: 4.634
Authors: Nigel Field; Philip Prah; Catherine H Mercer; Greta Rait; Michael King; Jackie A Cassell; Clare Tanton; Laura Heath; Kirstin R Mitchell; Soazig Clifton; Jessica Datta; Kaye Wellings; Anne M Johnson; Pam Sonnenberg Journal: BMJ Open Date: 2016-03-23 Impact factor: 2.692