Benjamin P Brown1, Julie Chor2, Luciana E Hebert3, M Elizabeth Webb4, Amy K Whitaker5. 1. University of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, 5841 S. Maryland Ave. - MC2050, Chicago, IL 60637.. Electronic address: benjamin_brown@brown.edu. 2. University of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, 5841 S. Maryland Ave. - MC2050, Chicago, IL 60637.. Electronic address: jchor@bsd.uchicago.edu. 3. University of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, 5841 S. Maryland Ave. - MC2050, Chicago, IL 60637.. Electronic address: luciana.hebert@wsu.edu. 4. University of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, 5841 S. Maryland Ave. - MC2050, Chicago, IL 60637.. Electronic address: mwebb@bsd.uchicago.edu. 5. University of Chicago Medicine, Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, 5841 S. Maryland Ave. - MC2050, Chicago, IL 60637.. Electronic address: amyw@ppil.org.
Abstract
OBJECTIVES: We explored how negative stories about long-acting reversible contraception (LARC) - defined as a firsthand negative experience with LARC shared directly with the study participant - were involved in participants' decisions about whether to use LARC following abortion, and how counseling affected the influence of negative LARC stories on contraceptive choices. STUDY DESIGN: We performed a multi-methods study, embedded within a trial examining the impact of a theory-based counseling intervention on LARC uptake post-abortion. Participants completed a baseline survey to determine the influence of negative LARC stories. We subsequently invited respondents who reported having heard negative LARC stories to participate in a semi-structured qualitative interview. We analyzed quantitative data with univariate statistics. We analyzed qualitative data using thematic content analysis. RESULTS: Among the 60 participants, 16 (27%) reported having heard negative LARC stories. Two of the 16 (13%) planned to initiate LARC prior to counseling, compared to 18 of 44 women (41%) who had not heard negative LARC stories (p=0.06). Prior to counseling, 69% of participants with negative LARC stories reported that these stories made them less likely to use LARC. In qualitative interviews with 9 women, we identified several key themes: (1) negative LARC stories deterred LARC use; (2) friends and family were valued informants; (3) potential side effects were important to LARC decision-making; and (4) positive and negative features of the counseling encounter influenced the effect of negative LARC stories. CONCLUSIONS: Negative LARC stories are common among women presenting for abortion at our institution and may influence patient uptake of these methods. Implications This study uses a multi-methods approach to examine the influence of negative stories about long-acting reversible contraception (LARC) on decision-making about LARC. These findings can help providers elicit patients' needs in contraception counseling and generate hypotheses for future counseling research.
OBJECTIVES: We explored how negative stories about long-acting reversible contraception (LARC) - defined as a firsthand negative experience with LARC shared directly with the study participant - were involved in participants' decisions about whether to use LARC following abortion, and how counseling affected the influence of negative LARC stories on contraceptive choices. STUDY DESIGN: We performed a multi-methods study, embedded within a trial examining the impact of a theory-based counseling intervention on LARC uptake post-abortion. Participants completed a baseline survey to determine the influence of negative LARC stories. We subsequently invited respondents who reported having heard negative LARC stories to participate in a semi-structured qualitative interview. We analyzed quantitative data with univariate statistics. We analyzed qualitative data using thematic content analysis. RESULTS: Among the 60 participants, 16 (27%) reported having heard negative LARC stories. Two of the 16 (13%) planned to initiate LARC prior to counseling, compared to 18 of 44 women (41%) who had not heard negative LARC stories (p=0.06). Prior to counseling, 69% of participants with negative LARC stories reported that these stories made them less likely to use LARC. In qualitative interviews with 9 women, we identified several key themes: (1) negative LARC stories deterred LARC use; (2) friends and family were valued informants; (3) potential side effects were important to LARC decision-making; and (4) positive and negative features of the counseling encounter influenced the effect of negative LARC stories. CONCLUSIONS: Negative LARC stories are common among women presenting for abortion at our institution and may influence patient uptake of these methods. Implications This study uses a multi-methods approach to examine the influence of negative stories about long-acting reversible contraception (LARC) on decision-making about LARC. These findings can help providers elicit patients' needs in contraception counseling and generate hypotheses for future counseling research.
Authors: Amy K Whitaker; Michael T Quinn; Elizabeth Munroe; Summer L Martins; Stephanie Q Mistretta; Melissa L Gilliam Journal: Patient Educ Couns Date: 2016-05-09
Authors: Catalina N Rey; Gary J Badger; Heidi S Melbostad; Deborah Wachtel; Stacey C Sigmon; Lauren K MacAfee; Anne K Dougherty; Sarah H Heil Journal: Contraception Date: 2020-02-01 Impact factor: 3.375