title: A Qualitative Study of Factors That Influence Contraceptive Choice among Adolescent School-Based Health Center Patients.
abstract: OBJECTIVE
  Long-acting reversible contraceptive (LARC) methods can prevent teen pregnancy yet remain underutilized by adolescents in the United States. Pediatric providers are well positioned to discuss LARCs with adolescents, but little is known about how counseling should occur in pediatric primary care settings. We explored adolescent womens' attitudes and experiences with LARCs to inform the development of adolescent-centered LARC counseling strategies.
  
  
  METHODS
  Qualitative analysis of one-on-one interviews.
  
  
  METHODS
  Participants were recruited from 2 urban school-based, primary care centers.
  
  
  METHODS
  Thirty adolescent women aged 14-18 years, diverse in race/ethnicity, and sexual experience.
  
  
  METHODS
  Interviews were audio-recorded, transcribed, and coded using inductive and deductive coding.
  
  
  METHODS
  Major themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches.
  
  
  RESULTS
  Participants (mean age, 16.2 years; range, 14-18 years) represented a diverse range of racial and/or ethnic identities. Half (15/30) were sexually active and 17% (5/30) reported current or past LARC use. Five themes emerged regarding key factors that influence LARC choice, including: (1) strong preferences about device-specific characteristics; (2) previous exposure to information about LARCs from peers, family members, or health counseling sessions; (3) knowledge gaps about LARC methods that affect informed decision-making; (4) personal circumstances or experiences that motivate a desire for effective and/or long-acting contraception; and (5) environmental constraints and supports that might influence adolescent access to LARCs.
  
  
  CONCLUSIONS
  We identified 5 factors that influence LARC choice among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Electronic address: andrea.hoopes@childrenscolorado.org.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Hoopes
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Kelly
authors.initials: K
authors.lastname: Gilmore
authors.affiliation: Neighborcare Health, Seattle, Washington; Department of Pediatrics, Seattle Children's Research Institute/University of Washington School of Medicine, Seattle, Washington.
authors.forename: Janet
authors.initials: J
authors.lastname: Cady
authors.affiliation: The Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Aletha Y
authors.initials: AY
authors.lastname: Akers
authors.affiliation: Department of Pediatrics, Seattle Children's Research Institute/University of Washington School of Medicine, Seattle, Washington.
authors.forename: Kym R
authors.initials: KR
authors.lastname: Ahrens
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002755:Choice Behavior; D003267:Contraception / Q000379:methods / Q000523:psychology*; D003268:Contraception Behavior / Q000523:psychology*; D003376:Counseling; D003657:Decision Making; D005193:Family Planning Services; D005260:Female; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000523:psychology; D036301:Qualitative Research; D012572:School Health Services; D014481:United States
keywords: Adolescent health services; Contraception counseling; Contraceptive device; Intrauterine device; Qualitative methods