title: Counseling Adolescents About the Intrauterine Contraceptive Device: A Comparison of Primary Care Pediatricians With Family Physicians and Obstetrician-Gynecologists in the Bronx, New York.
abstract: BACKGROUND
  The intrauterine device (IUD) is a highly effective contraceptive, yet not all primary care providers (PCPs) counsel adolescents about IUDs. We sought to describe PCPs' frequency of counseling adolescents about IUDs and identify whether different factors are associated with frequent counseling by pediatricians compared with family physicians and gynecologists.
  
  
  METHODS
  Surveyed PCPs affiliated with a Bronx, New York academic institution.
  
  
  RESULTS
  Frequent counseling of female adolescents about IUDs.
  
  
  RESULTS
  Frequent counseling was lower in pediatricians compared with family physicians and gynecologists (35.8% and 81.6%, respectively, P < .001). Among all PCP types, frequent counseling was associated with feeling more competent counseling and managing expected IUD side effects (P < .001). Other significant variables included inserting IUDs themselves (P < .001, family physicians and gynecologists) or having access to an inserter in their office (P = .04, pediatricians).
  
  
  CONCLUSIONS
  Correlates of frequent IUD counseling differed according to PCP specialty. Our results suggest that interventions to increase IUD counseling should focus on improving PCPs' competency around counseling and side effect management as well as increasing access to IUD inserters.
authors: Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA surubin@montefiore.org.
authors: Susan E
authors: SE
authors: Rubin
authors: Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.
authors: Hillel W
authors: HW
authors: Cohen
authors: Columbia University Mailman School of Public Health, New York, NY, USA.
authors: John S
authors: JS
authors: Santelli
authors: Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.
authors: M Diane
authors: MD
authors: McKee
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D006176:Gynecology; D006801:Humans; D007434:Intrauterine Devices; D008297:Male; D009518:New York / Q000453:epidemiology; D009774:Obstetrics; D010372:Pediatrics; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012307:Risk Factors
keywords: adolescent female; community health service; counseling; intrauterine device; intrauterine device- copper; intrauterine device- medicated; physicians- primary care; primary health care
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