Kristl Tomlin1, Tammalynn Bambulas2, Maureen Sutton3, Vanessa Pazdernik4, Dean V Coonrod5. 1. Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona. Electronic address: kristldtomlin@gmail.com. 2. Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona; District Medical Group, Phoenix, Arizona. 3. Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona. 4. Department of Research Support, A.T. Still University, Mesa, Arizona. 5. Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona; District Medical Group, Phoenix, Arizona; Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Phoenix, Arizona.
Abstract
STUDY OBJECTIVE: To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group. DESIGN AND SETTING: Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care. PARTICIPANTS: Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014. INTERVENTIONS: Motivational interviewing within the context of adolescent-focused prenatal care. MAIN OUTCOME MEASURES: Rates of uptake of LARC within 13 postpartum weeks. RESULTS: The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks postpartum was 38% (95% confidence interval [CI], 29%-47%) compared with 18% (95% CI, 11%-28%) for standard care participants, with an adjusted odds ratio of LARC use of 2.8 (95% CI, 1.5-5.2). Among patients who received adolescent-focused prenatal care, most (27% vs 12.7%) were using an intrauterine device as opposed to an implantable contraceptive device. CONCLUSION: Participation in an adolescent-focused antepartum setting using motivational interviewing to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake compared with standard prenatal care.
STUDY OBJECTIVE: To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group. DESIGN AND SETTING: Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care. PARTICIPANTS: Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014. INTERVENTIONS: Motivational interviewing within the context of adolescent-focused prenatal care. MAIN OUTCOME MEASURES: Rates of uptake of LARC within 13 postpartum weeks. RESULTS: The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks postpartum was 38% (95% confidence interval [CI], 29%-47%) compared with 18% (95% CI, 11%-28%) for standard care participants, with an adjusted odds ratio of LARC use of 2.8 (95% CI, 1.5-5.2). Among patients who received adolescent-focused prenatal care, most (27% vs 12.7%) were using an intrauterine device as opposed to an implantable contraceptive device. CONCLUSION: Participation in an adolescent-focused antepartum setting using motivational interviewing to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake compared with standard prenatal care.
Authors: Barbara Wilkinson; Mustafa Ascha; Emily Verbus; Mary Montague; Jane Morris; Brian Mercer; Kavita Shah Arora Journal: Contraception Date: 2018-09-05 Impact factor: 3.375
Authors: William C Livingood; Katryne Lukens Bull; Staci Biegner; Andrew M Kaunitz; LaRonda Howard; Vanessa Jefferson; Pia Julia Geisselmaier; Isabelle Michel; Lori Bilello Journal: F S Rep Date: 2022-02-23