title: Motivational Interviewing to Promote Long-Acting Reversible Contraception in Postpartum Teenagers.
abstract: OBJECTIVE
  To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group.
  
  
  METHODS
  Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care.
  
  
  METHODS
  Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014.
  
  
  METHODS
  Motivational interviewing within the context of adolescent-focused prenatal care.
  
  
  METHODS
  Rates of uptake of LARC within 13 postpartum weeks.
  
  
  RESULTS
  The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks postpartum was 38% (95% confidence interval [CI], 29%-47%) compared with 18% (95% CI, 11%-28%) for standard care participants, with an adjusted odds ratio of LARC use of 2.8 (95% CI, 1.5-5.2). Among patients who received adolescent-focused prenatal care, most (27% vs 12.7%) were using an intrauterine device as opposed to an implantable contraceptive device.
  
  
  CONCLUSIONS
  Participation in an adolescent-focused antepartum setting using motivational interviewing to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake compared with standard prenatal care.
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona. Electronic address: kristldtomlin@gmail.com.
authors.forename: Kristl
authors.initials: K
authors.lastname: Tomlin
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona; District Medical Group, Phoenix, Arizona.
authors.forename: Tammalynn
authors.initials: T
authors.lastname: Bambulas
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona.
authors.forename: Maureen
authors.initials: M
authors.lastname: Sutton
authors.affiliation: Department of Research Support, A.T. Still University, Mesa, Arizona.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pazdernik
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, Arizona; District Medical Group, Phoenix, Arizona; Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Phoenix, Arizona.
authors.forename: Dean V
authors.initials: DV
authors.lastname: Coonrod
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D003267:Contraception / Q000379:methods* / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D062405:Motivational Interviewing / Q000379:methods*; D049590:Postpartum Period; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: Adolescent-focused prenatal care; Long-acting reversible contraceptives; Motivational interviewing; Rapid repeat pregnancy; Teenage pregnancy