Study Objective

To examine associations between provider counseling about specific contraceptive methods and method choices reported by adolescents.

Design

A cross-sectional, secondary analysis of the local 2015 Youth Risk Behavior Survey, to which we added 2 new/modified questions about long-acting reversible contraception (LARC).

Setting

Rochester, New York.

Participants

Female students in 9th-12th grade in the Rochester City School District.

Interventions

An anonymous, standardized survey was administered to collect data.

Main Outcome Measures

We studied associations between students’ reported contraceptive use and counseling (LARC, short-acting contraception [SAC], neither), health care factors, and potential risk/protective factors. Data were analyzed using bivariate and multivariate methods.

Results

Among 730 sexually active female respondents, 353/730 (49%) were African American and 182/730 (25%) were Other/Mixed race. 416/730 (57%) used no hormonal method at last sex, and 95/730 (13%) used LARC. 210/730 (29%) of participants recalled any LARC-specific counseling, and 265/730 (36%) any counseling on SAC. Recall of LARC and SAC counseling and use were significantly associated with speaking privately with a provider, but were not related to personal risk/protective factors. Multivariate analyses showed that recollection of LARC counseling was significantly associated with higher odds of using either LARC (adjusted odds ratio, 14.3; P < .001) or SAC (adjusted odds ratio, 2.1; P = .007). Recollection of either LARC or SAC counseling was associated with significantly lower odds of using no contraception.

Conclusion

Adolescents’ use of LARC was only 13%, but those who recalled contraceptive counseling had higher odds of using some hormonal method. Efforts are needed to improve provider counseling, maintain confidentiality, and identify effective methods to engage adolescents in meaningful, memorable discussions of LARC.

中文翻译：

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自我报告的青少年使用高效避孕方法：提供者的咨询是否重要？

研究目的

检查提供者关于特定避孕方法的咨询与青少年报告的方法选择之间的关联。

设计

对本地2015年青少年风险行为调查的次级分析，其中添加了2个有关长效可逆避孕（LARC）的新问题/修正问题。

设置

纽约州罗切斯特。

参加者

罗切斯特市学区9至12年级的女学生。

干预措施

管理了一个匿名的标准化调查以收集数据。

主要观察指标

我们研究了学生报告的避孕药具使用和咨询（LARC，短效避孕药[SAC]，两者均无），医疗保健因素以及潜在风险/保护因素之间的关联。使用双变量和多变量方法分析数据。

结果

在730位有性活跃的女性受访者中，非裔美国人为353/730（49％），其他/混合种族为182/730（25％）。416/730（57％）在性交时未使用激素方法，而95/730（13％）使用了LARC。210/730（29％）的参与者回忆起任何针对LARC的咨询，265/730（36％）的回忆针对SAC。召回LARC和SAC的咨询和使用与与服务提供者私下交谈有显着关联，但与个人风险/保护因素无关。多变量分析表明，对LARC咨询的回忆与使用LARC（调整后的优势比，14.3；P  <.001）或SAC（调整后的优势比，2.1；P）的较高机率显着相关。 = .007）。回忆LARC或SAC咨询与不使用避孕药的几率大大降低有关。

结论

青少年使用LARC的比例仅为13％，但是那些回忆避孕咨询的人使用荷尔蒙方法的几率更高。需要努力改善提供者的咨询，保持机密性，并确定有效的方法来使青少年参与有关LARC的有意义的，令人难忘的讨论。