title: Factors Associated With Interest in Same-Day Contraception Initiation Among Females in the Pediatric Emergency Department.
abstract: OBJECTIVE
  The purposes were to describe interest in hormonal contraception initiation among female adolescent in the emergency department (ED) and to assess for associations with factors known to increase pregnancy risk such as violence victimization.
  
  
  METHODS
  We used a computerized survey to assess sexual and dating practices, pregnancy history/likelihood, contraception use (including long-acting reversible contraception [LARC]) and concerns, contraception initiation interest, violence victimization, medical utilization, and demographics among sexually experienced females aged 14-19 years in our ED. The primary outcome was interest in contraception initiation. We compared responses between subgroups using the chi-square test.
  
  
  RESULTS
  A total of 168 adolescents participated (82% of approached; mean age 16.6 years; 41% white; 48% black; 21% commercial insurance). Interest in contraception initiation was high: 60% overall and 70% among those not using hormonal contraception (n = 96). Among those using non-LARC contraception (n = 59), 29% were interested in LARC initiation. Contraception/LARC interest was positively associated with lack of recent well care (p < .06) and concerns about cost (p < .01), privacy (p = .03), and where to obtain contraception (p < .01). Nearly all planned on avoiding pregnancy, although many (23%) used no contraception at last intercourse. One third (36%) reported violence victimization. Most (70%) reported ≥1 concern about contraception (most commonly cost).
  
  
  CONCLUSIONS
  Many reported behaviors and exposures, including violence victimization, that increase their risk for pregnancy and most expressed interest in same-day initiation of hormonal contraception, including LARC. These findings may inform novel strategies for increased adolescent access to contraception and pregnancy prevention through use of nontraditional sites such as EDs.
authors.affiliation: Division of Emergency and Urgent Care, Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri. Electronic address: mmiller@cmh.edu.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Miller
authors.affiliation: Division of Emergency and Urgent Care, Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Randell
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
authors.forename: Romina
authors.initials: R
authors.lastname: Barral
authors.affiliation: Center for Health Services Research, Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Sherman
authors.affiliation: Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D003267:Contraception / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000523:psychology*; D044363:Contraception, Postcoital; D019548:Crime Victims / Q000523:psychology; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D000066511:Intimate Partner Violence / Q000706:statistics & numerical data; D010372:Pediatrics; D012725:Sexual Behavior / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescent; Contraception behavior; Health planning; Prevention and control