title: Adolescent and Young Women's Contraceptive Decision-Making Processes: Choosing "The Best Method for Her".
abstract: OBJECTIVE
  To evaluate influences on adolescent and young women's contraceptive decision-making processes.
  
  
  METHODS
  We conducted 21 individual interviews with women who presented to an adolescent-focused Title X family planning clinic seeking a new contraceptive method. Data were collected using a semi-structured interview guide, audio-taped and transcribed. Three researchers independently coded the transcripts using grounded theory; codes were organized into overarching themes and discrepancies were resolved.
  
  
  RESULTS
  After identification of themes, we organized the conceptual framework of the decision-making process using the transtheoretical model of behavior change in which participants move through 4 stages: (1) contemplation, (2) preparation, (3) action, and (4) maintenance. When contemplating contraception, most of our participants were highly motivated to avoid pregnancy. During preparation, participants gathered information related to their contraceptive concerns. Participants cited peers as primary informants and healthcare providers as experts in the field. Participants integrated information received with their personal concerns about contraception initiation; the most common concerns were effectiveness, method duration, convenience, and side effects. When participants acted on choosing a contraceptive method they described how it fit their individual needs. They considered their contraceptive experiences unique and not necessarily applicable to others. During maintenance, they acted as informants for other peers, but most commonly expressed that each individual must choose "the best method for her."
  
  
  CONCLUSIONS
  When adolescent and young women select a contraceptive method they balance the benefits and risks of available methods portrayed by peers and provider in the context of their personal concerns. Peer influence appeared to be greatest when participants shared contraceptive concerns and goals.
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO. Electronic address: juliana.melo@ucdenver.edu.
authors.forename: Juliana
authors.initials: J
authors.lastname: Melo
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO.
authors.forename: Marissa
authors.initials: M
authors.lastname: Peters
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Teal
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO.
authors.forename: Maryam
authors.initials: M
authors.lastname: Guiahi
mesh_terms: D000293:Adolescent; D003267:Contraception / Q000379:methods*; D003268:Contraception Behavior; D003270:Contraceptive Agents / Q000494:pharmacology; D003273:Contraceptive Devices; D003657:Decision Making; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D011247:Pregnancy
chemical_list: D003270:Contraceptive Agents
keywords: Adolescent; Contraceptive uptake; Decision making; Qualitative