title: Barriers to adolescent contraception use and adherence.
abstract: OBJECTIVE
  The United States has the highest rate of adolescent pregnancy of the industrialized nations. Previously reported patient barriers to the use of contraception included an ambivalence about pregnancy; method side effects; difficulty using methods; lack of satisfaction with methods; concerns about safety; expense; and a lack of knowledge about long-acting reversible contraception (LARC). This survey aims to determine if there are additional barriers to contraception use and adherence among an ethnically diverse urban population.
  
  
  METHODS
  A 16-item survey with good interrater reliability was utilized in a pilot study to assess patient demographics, and contraceptive methods was distributed to female patients aged 13-21 years at Metropolitan Hospital Center from January to October of 2014. Data analysis was performed using the χ2-square analysis, ϕ-coefficient, Contingency Coefficient, Cramer's V, and Satterthwaite methods of analyses.
  
  
  RESULTS
  Concerns about contraceptive method side effects, more specifically, weight gain, irregular bleeding and long-term health risks, and worries about parents discovering their contraceptive habits were the major barriers to contraceptive use.
  
  
  CONCLUSIONS
  The identification of these barriers is critical in order to reduce the high rates of pregnancy in adolescents. Educating parents and their teenagers regarding the most effective methods may increase compliance and adherence. This study offers further support for the use of LARC to overcome perceived patient barriers.
authors.affiliation: Obstetrics and Gynecology, New York Medical College/Metropolitan Hospital 1901 First Avenue Room 4B5, New York, NY 10029,United States of America.
authors.forename: Camille
authors.identifier: http://orcid.org/0000-0001-8784-5118
authors.initials: C
authors.lastname: Clare
authors.affiliation: Obstetrics and Gynecology, New York Medical College/Metropolitan Hospital 1901 First Avenue Room 4B5, New York, United States of America.
authors.forename: Mary-Beatrice
authors.initials: MB
authors.lastname: Squire
authors.affiliation: School of Medicine, New York Medical College, Oachalla, New York,United States of America.
authors.forename: Karem
authors.initials: K
authors.lastname: Alvarez
authors.affiliation: School of Medicine, New York Medical College, Oachalla, New York,United States of America.
authors.forename: Julia
authors.initials: J
authors.lastname: Meisler
authors.affiliation: Obstetrics and Gynecology, New York Medical College/Metropolitan Hospital 1901 First Avenue Room 4B5, New York, United States of America.
authors.forename: Candice
authors.initials: C
authors.lastname: Fraser
keywords: adherence; adolescents; barriers; birth control; contraception; teens