Contraception Initiation in the Emergency Department: Adolescent Perspectives.

Document Type

Article

Publication Date

7-2024

Identifier

DOI: 10.1016/j.jadohealth.2024.02.022

Abstract

PURPOSE: The purpose of this study was to identify factors affecting contraceptive intention and behavior among adolescent females in the pediatric Emergency Department.

METHODS: We conducted a qualitative interview study nested within a larger prospective cohort study examining adolescent contraceptive counseling for females ages 15-18 years at-risk of unintended pregnancy presenting to the pediatric Emergency Department. Interviews were conducted in a subset of participants. The ecologically expanded Theory of Planned Behavior, expert opinion, and literature review informed the interview guide. Interviews were recorded, transcribed, coded and monitored for thematic saturation.

RESULTS: Twenty-eight interviews were analyzed. Mean age was 17.1 years. Themes were mapped to ecologically expanded Theory of Planned Behavior constructs. Within health system influences, prior contraceptive experiences and patient-clinician interactions were described. Within community influences, contraceptive education, knowledge and misinformation, teen pregnancy norms, and social media impacts were described. Within attitudes influences, side-effect and safety concerns, contraceptive motivations and teen pregnancy beliefs were described. Within subjective norm influences, peer and family impacts were described. Within perceived behavioral control, Emergency Department (ED) counseling intervention impacts were described.

DISCUSSION: We identified factors affecting contraceptive initiation/behavior among an ED adolescent population that otherwise may not have received contraceptive education in similar detail as provided by study clinicians. Adolescents' prior contraceptive and clinician interactions, limited access to contraceptive education, knowledge and misinformation, and side-effect and safety concerns affected initiation. Peer/family sharing and social media were leading contraceptive information sources. Future studies should incorporate insights into adolescent ED intervention design to make optimal use of resources while maximizing potential benefit.

Journal Title

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

Volume

75

Issue

1

First Page

147

Last Page

154

MeSH Keywords

Humans; Adolescent; Female; Emergency Service, Hospital; Pregnancy; Pregnancy in Adolescence; Contraception Behavior; Health Knowledge, Attitudes, Practice; Qualitative Research; Prospective Studies; Adolescent Behavior; Interviews as Topic; Contraception; Counseling

Keywords

Adolescent health/medicine; Contraception; Emergency medicine

Comments

Grants and funding

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