title: Peer counselling for the promotion of long-acting, reversible contraception among teens: a randomised, controlled trial.
abstract: OBJECTIVE
  To evaluate the impact peer counselling has on same-day desire for long-acting, reversible contraception (LARC) among adolescents attending a family planning clinic.
  
  
  METHODS
  A randomised, controlled trial of 110 adolescent females attending an outpatient clinic for contraception in 2013. Adolescents received either brief peer counselling about LARC with routine contraceptive counselling, or routine counselling alone. Bivariate analyses and multivariable logistic regression assessed the primary outcome of same-day desire for LARC and secondary outcomes of change in knowledge and attitudes regarding LARC.
  
  
  RESULTS
  Peer counselling was well received and 70% reported that it was helpful in contraceptive decision-making. Peer counselling did not affect same-day desire for LARC, however, adolescents who received the intervention were more likely to report increased knowledge and positive change in attitudes towards LARC (adjusted odds ratios: 6.6 (95% confidence interval: 2.0-22.0 and 6.4 (1.6-26.8), respectively). Factors positively associated with same-day LARC desire included greater reported peer contraceptive influence, peer use of LARC and social support. Twenty of the 36 adolescents who desired LARC at the end of their clinic visit did not receive one most commonly due to a need to schedule a specific appointment for the procedure and the need to return during a menstrual period for intrauterine device placement.
  
  
  CONCLUSIONS
  While brief, point-of-care peer counselling is well received, and can increase adolescent knowledge and positive attitude about our most effective contraceptive methods, barriers to same-day LARC placement limit immediate use.
authors: a Department of Obstetrics and Gynecology , Hospital of the University of Pennsylvania , Philadelphia , PA , USA ;
authors: Susan F
authors: SF
authors: Wilson
authors: a Department of Obstetrics and Gynecology , Hospital of the University of Pennsylvania , Philadelphia , PA , USA ;
authors: Nathalie
authors: N
authors: Degaiffier
authors: b Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics , Perelman School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.
authors: Sarah J
authors: SJ
authors: Ratcliffe
authors: a Department of Obstetrics and Gynecology , Hospital of the University of Pennsylvania , Philadelphia , PA , USA ;
authors: Courtney A
authors: CA
authors: Schreiber
mesh_terms: D000293:Adolescent; D003267:Contraception; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003376:Counseling / Q000379:methods*; D003657:Decision Making; D004343:Drug Implants; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007434:Intrauterine Devices; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D010379:Peer Group; D012944:Social Support; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants
keywords: Adolescent health; contraception; health behaviour; health promotion; patient education; reproductive health