Contraception最新文献

{"title":"CHANGES IN FREQUENCY AND DECISION-MAKING FOR FEMALE PERMANENT CONTRACEPTION FOLLOWING THE DOBBS DECISION","authors":"R Flink-Bochacki,&nbsp;S Pogge,&nbsp;A Cai,&nbsp;S Horvath","doi":"10.1016/j.contraception.2024.110644","DOIUrl":"10.1016/j.contraception.2024.110644","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to compare the frequency of female permanent contraceptive procedures before and after the <em>Dobbs v Jackson Women’s Health Organization</em> decision, and to assess impact of political factors on patient decision-making.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients who underwent interval permanent contraceptive procedures in New York and Pennsylvania, comparing a pre-<em>Dobbs</em> (7/1/2020-6/30/2022) and post-<em>Dobbs</em> cohort (7/1/2022-6/30/2023). The primary outcome was change in procedure volume; secondary outcomes included differences in patient characteristics. We implemented standardized decision-making documentation beginning summer 2022, which allowed assessment of patient considerations in the post-<em>Dobbs</em> cohort. We performed Student t-tests, chi square tests, and descriptive statistics in Stata SE.</div></div><div><h3>Results</h3><div>There were 429 procedures pre-<em>Dobbs</em> and 310 post-<em>Dobbs</em>, including 194 (26.3%) procedures in New York and 545 (73.7%) in Pennsylvania. Volume grew significantly at both institutions, together increasing from an average 8.9 to 12.9 procedures/month (p=0.009). Patients post-<em>Dobbs</em> were more often under age 30 (31.7% vs. 39.0%, p=0.039) and nulliparous (10.7% vs. 21.0%, p&lt;0.001). Decision-making documentation was recorded for 96 patients and was similar between sites, with 20% of patients considering future access to permanent contraception, 18% considering future access to reversible contraception, and 23% considering future access to abortion. At both sites, 47% of patients said their decision was somewhat or very related to current political events.</div></div><div><h3>Conclusions</h3><div>In two states without new abortion restrictions, permanent contraception was sought by more patients post-<em>Dobbs</em>, particularly younger and nulliparous patients. Fear of losing access to future reproductive options is integrated into reproductive decision-making, illustrating the wide-reaching impact of political threats to patient autonomy.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRENATAL GENETIC COUNSELORS’ CHANGING MEDICAL DOCUMENTATION PRACTICES IN THE AFTERMATH OF THE DOBBS V JACKSON SUPREME COURT DECISION","authors":"G Joseph,&nbsp;J Harris-Wai,&nbsp;L Riddle,&nbsp;J Silver,&nbsp;M Norton","doi":"10.1016/j.contraception.2024.110573","DOIUrl":"10.1016/j.contraception.2024.110573","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to identify and document the impacts of evolving abortion regulations on prenatal genetic counseling (GC) practice and training.</div></div><div><h3>Methods</h3><div>We conducted semi-structured qualitative interviews with 27 GC Masters program directors, instructors, and clinical supervisors in 15 states and performed thematic content analysis after inductive and deductive coding.</div></div><div><h3>Results</h3><div>We found that documentation practices are changing in states with abortion restrictions. GCs described their medical record documentation as becoming more “vague” or “generic.” Some reported using code words agreed upon among colleagues, making clinical notes more inconspicuous, or not documenting discussions about abortion altogether. Some relied on verbal rather than written communication. Further, GCs reported receiving vague guidance from their institutions’ legal teams, while those practicing in states with exceptions for lethal fetal anomalies highlight complexity in defining ‘lethal’ and specific documentation required to justify abortion. For those in protective states, it can be unclear how best to document care for patients referred from restrictive states.</div></div><div><h3>Conclusions</h3><div>In the aftermath of <em>Dobbs</em>, the risk calculus for documenting abortion, and even pregnancy status in the medical record is shifting. Our study shows GCs are changing documentation practices, sometimes in coordination with other providers (eg, maternal-fetal medicine and complex family planning), or with guidance from institutional lawyers, but often in ad hoc ways. Medical documentation has the potential to impact trust and rapport between patients and providers, care continuity, research and public health surveillance. Our results have implications for providers who work in care teams with GCs and are facing similar challenges in the post-<em>Dobbs</em> environment.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESTIMATING EMERGENCY CONTRACEPTION EFFICACY WITH LEVONORGESTREL AND COPPER INTRAUTERINE DEVICES","authors":"SE Nourse,&nbsp;AL Woodcock,&nbsp;KS Brown,&nbsp;DK Turok,&nbsp;A Gero,&nbsp;LM Gawron","doi":"10.1016/j.contraception.2024.110565","DOIUrl":"10.1016/j.contraception.2024.110565","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to determine observed vs. expected pregnancy risk among levonorgestrel 52 mg and copper T380A intrauterine device (IUD) emergency contraception (EC) users.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of participants in a 1:1 randomized controlled trial comparing levonorgestrel 52 mg IUD and copper T380A IUD EC users who reported all episodes of unprotected intercourse in the two weeks prior to enrollment. We estimated number of expected pregnancies via two established approaches (Trussell, 2003 and modified Wilcox, 2015) to create a range of expected pregnancy risk among methods using risk estimates per menstrual cycle day. With both approaches, we calculated the proportion of pregnancies prevented based on those expected using both the day of most recently reported unprotected intercourse and all reported current menstrual cycle unprotected intercourse.</div></div><div><h3>Results</h3><div>One pregnancy occurred among the 327 participants assigned to the levonorgestrel IUD with 137 (41.9%) reported multiple episodes of unprotected intercourse. No pregnancies occurred among the 328 participants randomized to the copper IUD with 142 (43.2%) reporting multiple episodes of unprotected intercourse. In the levonorgestrel IUD group, expected pregnancies ranged from 12.4 (Trussell)-14.8 (Wilcox) using only the most recent episode of unprotected intercourse to 22.0 (T)-26.3 (W) accounting for all episodes. In the copper IUD group, there were 12.6 (T)-15.0 (W) and 24.8 (T)-29.6 (T) expected pregnancies respectively. Levonorgestrel IUD users prevented 92.0 (T)-96.2 (W)% of pregnancies and copper IUD users experienced 100% pregnancy prevention.</div></div><div><h3>Conclusions</h3><div>Levonorgestrel IUDs for EC prevented 92% of expected pregnancies, approaching the 100% prevention rate observed in the copper IUD group.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PATIENT OUTCOMES WITH EARLY PREGNANCY COMPLICATIONS AFTER EXPOSURE TO AN EARLY PREGNANCY ASSESSMENT CLINIC","authors":"SI Amaya,&nbsp;J Zhang,&nbsp;A Chen,&nbsp;SK Mulwa,&nbsp;E Booker,&nbsp;TS Gémesi,&nbsp;A Henkel,&nbsp;K Shaw,&nbsp;J Shorter","doi":"10.1016/j.contraception.2024.110630","DOIUrl":"10.1016/j.contraception.2024.110630","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate the healthcare burden experienced by patients with early pregnancy complications seen in an early pregnancy assessment clinic (EPAC) and those never seen in an EPAC.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study evaluating patients 18 years and older who presented during the first 12 weeks of pregnancy with a complication including vaginal bleeding or pain, early pregnancy loss (EPL), pregnancy of unknown location (PUL), ectopic, or molar pregnancy. The primary outcome was the healthcare burden for patients seen in an EPAC compared to patients never seen in an EPAC. Healthcare burden was defined as the total number of encounters and the average time spent in the healthcare system.</div></div><div><h3>Results</h3><div>We obtained data from 241 patients between January 2021 and June 2022. Patients never seen in EPAC were more likely to be of Hispanic ethnicity (52% vs 30%, p&lt;0.001), have public or no insurance (59% vs 25%, p&lt;0.001), and report a non-English primary language (33% vs 10%, p&lt;0.001) compared with patients seen in an EPAC. The median (range) total number of healthcare encounters was 4 (2, 5.5) and 3 (2,5) in the EPAC and non-EPAC groups, respectively (p=0.3). The mean in-person healthcare encounter time (hours) was significantly higher in the non-EPAC group (327 vs 120, p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Patients never seen in an EPAC were more likely to have socioeconomic and language barriers compared to those seen in an EPAC. Increasing access to expedited evaluation and management of early pregnancy complications may improve patients’ healthcare experience.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DOES PSYCHOSOCIAL BURDEN DIFFER WHEN ACCESSING MEDICATION ABORTION USING NO-TEST, TELEHEALTH CARE COMPARED TO IN-PERSON CARE WITH ULTRASOUND?","authors":"MA Biggs,&nbsp;C Baba,&nbsp;LJ Ralph,&nbsp;R Schroeder,&nbsp;C McNicholas,&nbsp;A Hagstrom Miller,&nbsp;D Grossman","doi":"10.1016/j.contraception.2024.110622","DOIUrl":"10.1016/j.contraception.2024.110622","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore whether no-test, telehealth abortion care reduces the psychosocial burden of abortion care-seeking.</div></div><div><h3>Methods</h3><div>As part of a study on the safety and effectiveness of telehealth abortion care, from May 2021-March 2023, we surveyed and abstracted medical record data for 583 patients obtaining medication abortion ≤ 70 days gestation, English- or Spanish-speaking, ages ≥ 15 years at four abortion clinic organizations in six US states. We assessed three psychosocial burden dimensions (structural challenges, five items, α=0.80; lack of autonomy, three items, α=0.73; and others’ reactions to the pregnancy, two items, α=0.88, range 0–3) by study group (1) telehealth and mailing medications, (2) no-test and pick-up medications, and (3) in-person with ultrasound.</div></div><div><h3>Results</h3><div>A total 403 enrolled participants completed psychosocial burden items. In adjusted analyses, telehealth by mail was associated with fewer structural challenges than in-person care (-0.12, 95% CI -0.23,-0.00), mostly due to less difficulty traveling for care (24% vs 32%, p&lt;0.05). While mean lack of autonomy scores did not differ by study group, the telehealth by mail (11%) and no-test and pick-up (12%) groups were less likely to feel forced to wait for the abortion after making the decision, when compared to the in-person with ultrasound group (22%, p&lt;0.05). The no-test and pick-up group (35%) was also less likely to be worried about friends/family members’ reaction to the pregnancy than the in-person care group (42%, p&lt;0.05).</div></div><div><h3>Conclusions</h3><div>No-test, telehealth medication abortion care may reduce the psychosocial burden of abortion-seeking, in particular the burden of travel and feeling forced to wait for care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POSTPARTUM PERMANENT CONTRACEPTIVE PROCEDURES: A 360-DEGREE QUALITATIVE INVESTIGATION","authors":"K Crofton,&nbsp;A Johnston,&nbsp;S Kaszubinski,&nbsp;S Betstadt,&nbsp;E Tal,&nbsp;R Flink-Bochacki","doi":"10.1016/j.contraception.2024.110628","DOIUrl":"10.1016/j.contraception.2024.110628","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore interdisciplinary factors affecting completion of postpartum permanent contraceptive procedures after vaginal delivery.</div></div><div><h3>Methods</h3><div>We conducted a multi-center qualitative study on completion or non-completion of postpartum permanent contraceptive procedures at three academic institutions from July 2023-March 2024. We recruited postpartum patients who desired permanent contraceptive procedures following vaginal delivery. We conducted semi-structured interviews with patients and their nursing, obstetric, and anesthesia teams. We double-coded transcripts using Dedoose and performed inductive thematic content analysis, concluding data collection after thematic saturation.</div></div><div><h3>Results</h3><div>We interviewed 19 patients (11 completed and 9 non-completed procedures) and 47 staff (mean 2.5/patient). We identified three major themes: (1) Standard perioperative counseling can be overshadowed by a focus on overcoming obstacles to completion (<em>“What did [your doctors] tell you to expect?” “Really nothing, they just asked if I was sure I want it…”</em>); (2) Healthcare workers’ personal values influence the prioritization of these procedures <em>(“I believe that some are elective and some are more urgent”)</em>; (3) Procedure completion often relies on one champion to optimize interdisciplinary communication and push past barriers (<em>“We could not get a slot for her on day 1…and then we did on day 2, mostly because [attending] advocated for her</em>”).</div></div><div><h3>Conclusions</h3><div>Unlike most surgeries, the completion of postpartum permanent contraceptive procedures centers around overcoming barriers to access rather than patient needs. The propensity for clinician advocacy to detract from perioperative patient care is a novel finding, and it sustains a culture where contraceptive requests are actualized based on care-team factors rather than patient factors.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ATTRIBUTES OF PROVIDER COUNSELING ASSOCIATED WITH CONTRACEPTIVE SATISFACTION","authors":"N Luche,&nbsp;E Mosley,&nbsp;N Zite,&nbsp;S Borrero","doi":"10.1016/j.contraception.2024.110646","DOIUrl":"10.1016/j.contraception.2024.110646","url":null,"abstract":"<div><h3>Objectives</h3><div>High-quality contraceptive counseling is associated with increased use of contraception. However, little is known about how counseling influences patient satisfaction with contraceptive method. This study sought to assess characteristics of counseling associated with method satisfaction.</div></div><div><h3>Methods</h3><div>Pregnant participants aged 21-45 years considering postpartum tubal sterilization were recruited from three sites and randomized to receipt of the MyDecision/MiDecisión decision aid tool vs. standard care. Surveys at three months postpartum included eight Likert scale items characterizing perinatal contraceptive counseling quality, and one item assessing current contraceptive method satisfaction. Response options of “strongly agree” (positively worded items) or “strongly disagree” (negatively worded items) were considered optimal. We examined bivariate associations between optimal counseling and optimal method satisfaction. Logistic regression models were then conducted, adjusted for randomization arm and confounding variables (p&lt;0.10) identified in bivariate analysis (age, site).</div></div><div><h3>Results</h3><div>Of 244 participants, 160 (65.6%) reported optimal method satisfaction. In bivariate analysis, optimal ratings on feeling respected, feeling pressured into sterilization or other methods, receiving adequate explanations regarding sterilization or other methods, receiving answers to questions, and counseling satisfaction were all associated with optimal method satisfaction (all p&lt;0.01). In adjusted analysis, optimal ratings on feeling respected (adjusted OR (aOR):5.80;95%CI:2.32-14.49), receiving adequate explanations regarding non-sterilization contraception (aOR:2.14;95%CI:1.07-4.30), feeling minimally pressured into non-sterilization methods (aOR:2.30;95%CI:1.01-5.22), receiving answers (aOR:3.35;95%CI:1.43-7.83), and counseling satisfaction (aOR:4.61;95%CI:2.18-9.74) remained significantly associated with method satisfaction.</div></div><div><h3>Conclusions</h3><div>Aspects of provider contraception counseling that are aligned with patient-centered care are significantly associated with contraceptive method satisfaction. Provision of high-quality contraceptive counseling may have implications both for uptake and continued use of methods.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DECEIVED, PRAGMATIC, STRATEGIC: ABORTION-SEEKERS’ APPROACHES TO CONTACTING CRISIS PREGNANCY CENTERS FOLLOWING TEXAS SENATE BILL 8","authors":"A Chatillon,&nbsp;W Arey,&nbsp;K Lerma,&nbsp;G Alemán,&nbsp;J Draper,&nbsp;A Beasley,&nbsp;K White","doi":"10.1016/j.contraception.2024.110590","DOIUrl":"10.1016/j.contraception.2024.110590","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore pregnant Texans’ experiences with crisis pregnancy centers (CPCs) following implementation of Senate Bill 8 (SB8), which prohibited abortions after embryonic cardiac activity.</div></div><div><h3>Methods</h3><div>Between October 2021 and August 2022, we conducted in-depth interviews with English-speaking Texans aged ≥15 years who were seeking abortion about their experiences navigating to care. We recruited participants through online ads and by providing flyers to abortion facilities in seven states. We interviewed Texans with varied pregnancy outcomes, including out-of-state abortions, self-managed abortions, and continued pregnancies, all of whom initially sought abortion in Texas. We used inductive and deductive coding to identify themes in participants’ understandings of and experiences with CPCs.</div></div><div><h3>Results</h3><div>Of 120 participants, 36 contacted CPCs. Roughly half the 36 were <em>deceived</em>: they reached out for support accessing abortion care, unaware of CPCs’ mission to prevent abortion. Most remaining participants contacted CPCs <em>pragmatically</em>: unaware of CPCs’ missions, they were simply drawn to the organizations’ free and accessible pregnancy tests/ultrasounds. A minority, however, knew of CPCs’ missions and used CPCs’ pregnancy confirmation/dating <em>strategically</em> to determine next steps toward an abortion. Participants with pragmatic interactions more often reported positive experiences with CPCs, while those who were deceived or strategic frequently described negative experiences. Regardless of motivation, participants noted the importance of having free and accessible services, including pregnancy tests and ultrasounds, in their communities.</div></div><div><h3>Conclusions</h3><div>In a restrictive abortion setting with limited access to reproductive and pregnancy-related healthcare services, pregnant Texans sought free services from CPCs instead of medical professionals, including for pragmatic or strategic reasons.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOCIATION BETWEEN EXPERIENCES OF DISCRIMINATION AND CONCERNS ABOUT ACCESSING CONTRACEPTIVE CARE AMONG COMMUNITY COLLEGE STUDENTS IN TEXAS AND CALIFORNIA","authors":"LA Tello Perez,&nbsp;J Yarger,&nbsp;HK Hecht,&nbsp;K Hopkins,&nbsp;I Rossetto,&nbsp;C Harper","doi":"10.1016/j.contraception.2024.110640","DOIUrl":"10.1016/j.contraception.2024.110640","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to identify whether experiences of discrimination are associated with students’ concerns about accessing contraception.</div></div><div><h3>Methods</h3><div>We analyzed baseline data (n=2,086) from an ongoing cluster randomized trial in Texas and California with sexually active community college students aged 18-25, assigned female at birth (gender- inclusive). Experiences of Discrimination (EOD) were measured using a validated and reliable scale (α = 0.8). We examined the association between EOD and concerns about being judged or disrespected by a medical provider, and whether the student felt comfortable discussing contraception with a provider. We used mixed effects logistic regression for clustered data, controlling for key sociodemographic factors.</div></div><div><h3>Results</h3><div>Overall, 21% of participants reported concerns about being judged or disrespected, and 17% reported feeling uncomfortable discussing contraception. EOD positively correlated with concerns about judgment or disrespect (adjusted OR (aOR)=1.13, CI 95% 1.09-1.16) and discomfort discussing contraception (aOR=1.04, CI 95% 1.01-1.08). Asian/Pacific Islanders had higher odds of worrying about judgment/disrespect (aOR=1.95, CI 95% 1.28-2.99) and discomfort discussing contraception (aOR=1.99, CI 95% 1.25-3.16) compared to White students. Latinx students also had higher odds of discomfort discussing contraception (aOR=1.52, CI 95% 1.04-2.23) as did first-generation college students (aOR=1.37, CI 95% 1.04-1.80). Finally, not speaking English at home was associated with concerns about judgment or disrespect (aOR=1.31, CI 95% 1.01-1.70).</div></div><div><h3>Conclusions</h3><div>Experiences of discrimination are associated with concerns about being judged or disrespected, as well as discomfort discussing contraception with providers. Healthcare providers and institutions should recognize and work to reduce the impact of discrimination on patients, particularly among young and marginalized patient communities.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IS TIKTOK THE NEW CONTRACEPTIVE COUNSELOR? DESCRIBING CONTRACEPTIVE SIDE EFFECTS DISCOURSE ON TIKTOK","authors":"E Pleasants,&nbsp;B Whitfield,&nbsp;ZH Pleasure,&nbsp;C Smith,&nbsp;E Norrell,&nbsp;C Fallon,&nbsp;L Lindberg","doi":"10.1016/j.contraception.2024.110632","DOIUrl":"10.1016/j.contraception.2024.110632","url":null,"abstract":"<div><h3>Objectives</h3><div>To quantify the frequency and characterize discussions of contraceptive side effects in popular TikTok videos.</div></div><div><h3>Methods</h3><div>We used two third-party TikTok scrapers to collect the most-viewed TikToks using hashtags (#contraception, #birthcontrol) and search terms (“contraception”, “birth control”). The study team screened each TikTok for mention of the effects of using or not using contraception (‘side effects’), excluding irrelevant videos. Qualitative thematic analysis captured the contraceptive method(s) and side effect(s) discussed.</div></div><div><h3>Results</h3><div>We identified 805 relevant TikToks with at least one-million views. Preliminarily, 54% discussed contraceptive side effects, and video creators included contraceptive users, healthcare providers, and wellness influencers. In TikToks about side effects, videos most commonly discussed the contraceptive pill (28%), intrauterine device (IUD) (13%), and implant (9%). Nearly one-quarter of videos were about unspecified hormonal methods. Discussions of side effects mostly focused on people’s experiences with the effects of using or stopping contraceptives, including changes in weight, mood, attraction to sexual/romantic partners, and pain from device insertion. A substantial portion of videos focused on the perceived short- and long-term risks of hormonal contraception and discontinuation of hormonal contraception as an empowering health decision.</div></div><div><h3>Conclusions</h3><div>Over half of the most-viewed TikToks about contraception discussed side effects, suggesting that these videos perform well in the TikTok algorithm as highly resonant or attention-capturing. Our findings suggest that individuals who search TikTok for contraception information likely see videos about side effects, which has ramifications for contraceptive perceptions and use. Providers should continue to consider the influences of TikTok on contraceptive perceptions and decision making.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}