title: Barriers and Facilitators to Adolescents' Use of Long-Acting Reversible Contraceptives.
abstract: Most pregnancies among teenagers are unintended and many can be attributed to contraception misuse or nonuse. The etonogestrel implant and intrauterine devices, referred to as long-acting reversible contraceptives, or LARCs, are the most effective reversible contraceptive methods. These methods are safe for use by adolescents, yet the number of LARC users remains low among adolescents in the United States. In this review we examine recent literature about barriers and facilitators to LARC use among adolescent women. Factors that influence decision-making and provision are organized into 4 categories: (1) cost and clinical operations; (2) adolescent awareness and attitudes; (3) confidentiality, consent, and parental attitudes; and (4) health care provider knowledge, attitudes, and counseling. Knowledge deficits and misconceptions among adolescents and their health care providers are key barriers to adolescent LARC use.
authors.affiliation: Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Pritt
authors.affiliation: Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio; Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Alison H
authors.initials: AH
authors.lastname: Norris
authors.affiliation: Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio. Electronic address: elise.berlan@nationwidechildrens.org.
authors.forename: Elise D
authors.initials: ED
authors.lastname: Berlan
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002755:Choice Behavior; D003219:Confidentiality; D003267:Contraception / Q000523:psychology / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D017135:Desogestrel / Q000627:therapeutic use*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D014481:United States
chemical_list: D003271:Contraceptive Agents, Female; C044815:etonogestrel; D017135:Desogestrel
keywords: Adolescents; Barriers; Contraception; Long-acting reversible contraception; Qualitative; Teen pregnancy