title: Contraception Delivery in Pediatric and Specialist Pediatric Practices.
abstract: OBJECTIVE
  To characterize pediatricians' knowledge, attitudes, and self-efficacy around contraception.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  United States.
  
  
  METHODS
  National sample of pediatricians.
  
  
  METHODS
  Assessment of behaviors of providing contraception.
  
  
  METHODS
  Reproductive health practice score.
  
  
  RESULTS
  Two hundred twenty-three usable surveys were received, from 163 contraceptive prescribers and 60 nonprescribers. The mean reproductive health practice score was 43.1 (SD, 8.2; total possible score, 84). Prescribers differed in their mean reproductive health score (46.0; SD, 7.0) from nonprescribers (34.0; SD, 4.5; P < .001). Prescribers vs nonprescribers differed in their attitude and efficacy in providing contraception. More prescribers believed it was their responsibility to ask about patients' need for birth control, were confident in their ability to prescribe contraception options, and provided contraception to minors despite parental disapproval. Neither group was confident in their ability to place intrauterine devices or believed that the literature supports intrauterine device placement in adolescents. Only efficacy was related to prescribing contraception in a multivariate regression analysis (odds ratio, 1.7; P < .001).
  
  
  CONCLUSIONS
  In this study, we showed that most pediatricians are contraception prescribers but the overall reproductive health score was low for prescribers and nonprescribers. The odds of prescribing contraception increased with higher self-efficacy scores rather than knowledge alone. Many prescribers and nonprescribers would not prescribe birth control if parents disapproved and do not believe it is their responsibility to assess patients' need for birth control. In addition very few pediatricians have training in long-acting reversible contraception, despite being the recommended method for adolescents.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, L4000 Women's Hospital, Ann Arbor, Michigan. Electronic address: alexa.p.kaskowitz@kp.org.
authors.forename: Alexa
authors.initials: A
authors.lastname: Kaskowitz
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, L4000 Women's Hospital, Ann Arbor, Michigan.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Quint
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, L4000 Women's Hospital, Ann Arbor, Michigan.
authors.forename: Melissa
authors.initials: M
authors.lastname: Zochowski
authors.affiliation: Summer Biomedical Research Program, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Amy
authors.initials: A
authors.lastname: Caldwell
authors.affiliation: Summer Biomedical Research Program, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Kavita
authors.initials: K
authors.lastname: Vinekar
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, L4000 Women's Hospital, Ann Arbor, Michigan.
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Dalton
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003267:Contraception / Q000379:methods / Q000523:psychology*; D003270:Contraceptive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007434:Intrauterine Devices; D008297:Male; D008511:Medicine / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D000072143:Pediatricians / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D034121:Reproductive Health Services / Q000706:statistics & numerical data; D020377:Self Efficacy; D014481:United States
chemical_list: D003270:Contraceptive Agents
keywords: Adolescents; Birth control; Contraception; Pediatricians; Self-efficacy; Subspecialist pediatricians