Journal of women's health (2002)最新文献

{"title":"Female Genital Mutilation: The Zero Tolerance Imperative.","authors":"Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen","doi":"10.1177/15409996251387196","DOIUrl":"https://doi.org/10.1177/15409996251387196","url":null,"abstract":"","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postmenopausal Bone Loss in American Indian Women.","authors":"Misti J Leyva, Christopher E Aston, Lancer D Stephens, Mary Zoe Baker, Brenda J Smith","doi":"10.1177/15409996251384811","DOIUrl":"https://doi.org/10.1177/15409996251384811","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study aimed to investigate whether American Indian heritage influences the rate at which bone loss occurs in postmenopausal women and factors that affect this response. <b><i>Methods:</i></b> Secondary analyses were performed on a subpopulation of women (<i>n</i> = 107) from the Oklahoma American Indian Women's Osteoporosis Study cohort who completed a baseline and 1-year follow-up visit. DXA scans of lumbar spine, hip and forearm, serum biomarkers, medical history, calcium intake, and physical activity were assessed at each visit. Data were stratified by American Indian heritage or blood quantum (BQ) into <50% (BQ1) and ≥50% (BQ2), and the associations between BQ and percent change in hip, lumbar spine, and forearm bone mineral content (BMC) and density (BMD) were investigated using regression analyses with <i>p</i> ≤ 0.05 considered significant. <b><i>Results:</i></b> At baseline and at the 1-year follow-up visits, participants in BQ2 had significantly higher BMD at the hip (i.e., femur neck and intertrochanter), but not at the lumbar spine or forearm. When controlling for years post menopause and baseline bone measures, no differences in BMD change were observed between BQ groups, and only the change in BMC of the hip trochanteric region was greater in BQ2 (<i>p</i> < 0.05) than in BQ1. When adjustments were made for environmental factors (e.g., calcium intake, physical activity, and smoking), the percent decline in BMD at the hip (i.e., intertrochanter and total hip) was significantly greater in BQ2 compared with BQ1. Physical activity accounted for the greatest variance. <b><i>Conclusions:</i></b> In this cohort, postmenopausal women with American Indian heritage had a higher BMD at some regions of the hip, but they experienced bone loss at a similar rate to non-Hispanic White women. Maintenance of a physically active lifestyle was especially important in this population.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Shifts in Prescription Dispensing Patterns: A Descriptive Analysis before and During the Initial Year of the COVID-19 Pandemic by Sex and Age.","authors":"Joyce O Obidi, Erin M South, Modupeola Adereti, John Rhee, Kaveeta Vasisht, Susan Bersoff-Matcha","doi":"10.1177/15409996251384550","DOIUrl":"https://doi.org/10.1177/15409996251384550","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To explore the most dispensed drug categories in females and males in the United States and to examine sex differences in dispensed therapeutics before and during the COVID-19 pandemic. <b><i>Design:</i></b> This descriptive study utilizes prescription dispensing data to assess drug therapeutic category trends before and during the COVID-19 pandemic. <b><i>Setting:</i></b> This study draws data from US outpatient pharmacies to provide insights into prescription dispensing practices. <b><i>Participants:</i></b> The analysis encompasses a wide range of patients accessing outpatient pharmacy services (from Symphony Health Metys® [Metys®] database), categorized by sex and age, for the period January 1, 2019-December 31, 2020. <b><i>Interventions/Exposures:</i></b> The study focuses on prescription dispensing patterns without any specific interventions or exposures. <b><i>Main Outcomes and Measures:</i></b> The main outcomes include the identification of the most dispensed therapeutic categories, their distribution by sex and age, and any differences in prescription dispensing. <b><i>Results:</i></b> Across various age groups, psychotherapeutic drugs and respiratory therapies were consistently among the most dispensed therapeutic categories for males and females. Vascular agents emerged as a top choice for those aged 41 years and above. Contraceptives were prevalent among females aged 17 to 40 years. Furthermore, females received more prescriptions than males across most categories. Notably, between the pre-pandemic (2019) and pandemic periods (2020), the prescriptions dispensed differed by an estimated 15 million prescriptions. <b><i>Conclusions and Relevance:</i></b> This study sheds light on prescription dispensing trends before and during the COVID-19 pandemic. The findings offer valuable insights into medication utilization by sex and age and the potential effects of the pandemic on dispensing patterns.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Estrogen Adherence: A Prospective Pilot Study.","authors":"Feven W Getaneh, Jon F Pennycuff, Hannah Kelly, Haley McCann, Paul Kolm, Robert E Gutman","doi":"10.1177/15409996251363800","DOIUrl":"10.1177/15409996251363800","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Local estrogen therapy (LET) has many benefits, but little is known regarding adherence and reasons for discontinuation. We aimed to evaluate fill/continuation rates of LET and assess factors associated with not filling/discontinuation. <b><i>Materials and Methods:</i></b> Prospective observational study of adult women newly prescribed LET. Participants completed Pelvic Floor Distress Inventory 20 (PFDI-20) and the Day-to-Day Impact of Vaginal Aging (DIVA) at baseline, 3-, 6-, and 12-months from initial prescription. Participants who discontinued LET were queried regarding reason for discontinuation. <b><i>Results:</i></b> A total of 155 participants were included. Mean age was 65 (+/-10) and 57% had private insurance. The most common indications for prescription with LET were atrophic vaginitis 61 (39%) and recurrent urinary tract infection 34 (22%). At baseline, 94% filled initial prescription. Continuation rates were 78%, 90%, and 79% at 3-, 6-, and 12-months, respectively, but 93 (60%) were lost to follow-up over the study period. Common reasons for not starting LET included cost (33%) and concern for side effects (22%). Common reasons for discontinuing were mess of using therapy (19%) and concern for side effects (16%). PFDI-20 and DIVA domain scores except self-concept decreased across all timepoints for all participants with no difference between women who continued versus discontinued LET. Univariate analysis did not find any factors associated with LET discontinuation. <b><i>Conclusions:</i></b> LET use is associated with improved pelvic floor and vaginal symptoms up to 12 months following initiation. Prospective evaluation was challenging due to high loss to follow-up. A total of 26% discontinued LET over 1 year. Barriers to initiation and discontinuation such as cost, mess, and concern for side effects are potentially modifiable factors that physicians can address to improve adherence.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1240-1246"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Sex Inclusivity: Perspectives on Sex as a Biological Variable.","authors":"Shanen M Mulles, Daniel Z Aziz, C Chase Binion, Neha Pai, Sophia L Maragos, Meredith E Flattum, Monica Kowalczyk, Anna Volerman, Teresa K Woodruff, Melina R Kibbe","doi":"10.1089/jwh.2024.1009","DOIUrl":"10.1089/jwh.2024.1009","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The National Institutes of Health (NIH) policy on sex as a biological variable (SABV) was implemented in 2016 to encourage researchers to consider both sexes within their study design. However, there continues to be ongoing debate regarding the utility of this initiative. This study aimed to evaluate opinions of the SABV policy among study section members and how these varied by self-reported sex. <b><i>Method:</i></b> An 18-question survey was sent <i>via</i> email in 2023 to 20,803 study section members who participated in a review session from May 15 to July 15 in 2020, 2021, 2022, or 2023. Survey questions were based on a previously published study surveying study section members from 2016 to 2017 to allow for comparison of results. <b><i>Results:</i></b> A total of 3,699 individuals responded to the survey (17.7%). Among respondents, 52.1% self-identified as male, and 69.8% conduct basic/translational research. Fewer respondents received resources to learn about the policy in 2020-2023 compared to 2016-2017 (<i>n</i> = 2,147, 58.0% versus <i>n</i> = 848, 73.0%, <i>p</i> < 0.001). More respondents in 2020-2023 felt that considering SABV would improve the rigor and reproducibility of NIH-funded research compared to 2016-2017 (<i>n</i> = 2,630, 71.1% versus <i>n</i> = 654, 56.3%, <i>p</i> < 0.001). However, only 2,358 (63.7%) respondents felt it was important for all NIH-funded research to consider SABV within experimental design, similar to 2016-2017 (<i>n</i> = 766, 66.0%, <i>p</i> = 0.2). Fewer male respondents compared to female respondents felt considering SABV would improve rigor and reproducibility (<i>n</i> = 1,325, 68.8% versus <i>n</i> = 1,285, 74.6%, <i>p</i> < 0.001), and fewer male compared to female respondents felt it was important for all NIH-funded research to consider SABV within their experimental design (<i>n</i> = 1171, 60.9% versus <i>n</i> = 1170, 67.9%, <i>p</i> < 0.001). <b><i>Conclusions:</i></b> Since the implementation of the SABV policy, diverse perspectives continue to exist among study section members. Continued efforts are required in order to understand how sex can be incorporated into research for the benefit of all people.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1204-1212"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Age of Menopause and Hysterectomy Status and Alzheimer's Disease Risk in a Cohort of Older White and Black Women.","authors":"Amalia Peterson, Eliza C Miller, Philip L De Jager, Justina Avila-Rieger, Miguel Arce Rentería, Aaliyah Reed, Timothy J Hohman, Angela L Jefferson, Lisa L Barnes, Zoe Arvanitakis, David A Bennett, Sarah E Tom","doi":"10.1177/15409996251363798","DOIUrl":"10.1177/15409996251363798","url":null,"abstract":"<p><p><b><i>Background and Objectives:</i></b> To determine whether age at menopause and premenopausal hysterectomy status are associated with incident Alzheimer's disease (AD) dementia in a group of older community-dwelling women. <b><i>Materials and Methods:</i></b> Participants from the Rush Memory and Aging Project, the Religious Orders Study, and the Minority Aging Research Study were included (<i>n</i> = 2,862, baseline age 77.1 ± 7.7 years, follow-up 8.6 ± 5.6 years, 24% Black, and 75% White). Age at menopause and premenopausal hysterectomy status were based on self-report at study entry. AD dementia diagnosis was determined annually based on the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria. The hazard of AD dementia was evaluated using Cox-proportional regression models, with age as the time axis, adjusted for race, early life socioeconomic status, and education. To explore possible differences in risk by race, models were repeated using White and Black women propensity score-matched on age at baseline, education, and number of follow-up visits. <b><i>Results:</i></b> Menopause before age 45 years was associated with a 33% greater hazard of AD dementia compared with menopause after age 50 years (hazard ratio [HR] = 1.33, 95% confidence interval [CI]: 1.10-1.59). Hysterectomy was not associated with hazard of AD dementia (HR = 1.08, CI: 0.94-1.26). The association between age at menopause and hysterectomy status and AD dementia was not different for White and Black women. <b><i>Conclusions:</i></b> Some sex-specific menopausal characteristics, such as age at menopause, relate to the hazard of AD dementia. Given the disproportionate burden of AD in women, research is needed to explore potential mechanisms for this finding.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1195-1203"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent Class Analysis of Well-Being in Older Women.","authors":"Eileen Rillamas-Sun, Nancy F Woods, Kenneth C Pike, Andrea Z LaCroix, Oleg Zaslavsky, Adrian Dobra, Marcia L Stefanick, Barbara B Cochrane","doi":"10.1177/15409996251363398","DOIUrl":"10.1177/15409996251363398","url":null,"abstract":"<p><p><b><i>Background:</i></b> Previous efforts to assess well-being and health focused on individual indicators of hedonic, evaluative, or eudaemonic measures or summated scores reflecting all dimensions. The objectives of this study were to develop profiles that preserve distinct dimensions of hedonic, evaluative, and eudemonic well-being while permitting its exploration as a predictor of health endpoints. <b><i>Methods:</i></b> A total of 81,148 Women's Health Initiative (WHI) participants with well-being measures collected in 2011-2012 (mean age = 76.4 years) were included. Women were recruited to the WHI Clinical Trial and Observational Cohort, continued participation in WHI Extensions (2005-2010 and 2010-2015), and completed the 2011-2012 questionnaire. Classes were identified from hedonic (life enjoyment, happiness, life satisfaction, quality of life) and eudaemonic (personal growth, purpose in life, environmental mastery, self-mastery, self-control) measures using latent class analysis. Characteristics were described by classes, and associations with all-cause mortality were examined using logistic regression. <b><i>Results:</i></b> Four well-being classes were identified. Class 2 (17.8%) had the lowest (worst) well-being scores, and class 4 (53.9%) had the highest (best) well-being scores in all dimensions. Class 1 (6.4%) had high hedonic and moderate eudaemonic with low life enjoyment. Class 3 (21.9%) had high hedonic and moderate eudaemonic scores with low self-mastery. Women in class 4 were younger, more educated, reported higher annual incomes, least likely to smoke, and most likely to drink alcohol daily. Relative to class 4, odds ratios (95% confidence interval) of all-cause mortality were 1.33 (1.24-1.43), 1.75 (1.67-1.84), and 1.26 (1.20-1.31) for classes 1, 2, and 3, respectively, even after adjustment for demographic and behavioral confounders. <b><i>Conclusion:</i></b> Latent class analysis identified groups by levels of hedonic and eudaemonic indicators, preserving information about well-being dimensions while supporting interpretation of relationships with well-being important to older women and health research.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1273-1281"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desire for Sterilization Reversal: Differences by Rural/Urban Area, Method of Payment, and Facility Type.","authors":"Emma Pliskin, Elizabeth Wildsmith, J S Manlove, Kate Welti","doi":"10.1089/jwh.2024.0713","DOIUrl":"10.1089/jwh.2024.0713","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Sterilization is more common in rural areas than in urban areas. We assessed whether desire for sterilization reversal also differs by rural/urban areas and by aspects of the sterilization care visit-specifically, method of payment and type of facility. <b><i>Methods:</i></b> We used data from 469 female 2015-2019 National Survey of Family Growth respondents who received a tubal ligation in the last 5 years. Multivariate logistic regression tested associations between wanting a sterilization reversal and residence, method of payment, and facility type, controlling for sociodemographic factors. <b><i>Results:</i></b> Overall, roughly one-quarter of respondents living in rural and urban areas wanted a reversal. Receiving a tubal ligation at a public facility was associated with lower odds of desire for reversal (adjusted odds ratio [aOR] = 0.48, <i>p</i> = 0.04, confidence intervals [CIs]: 0.24-0.97). Additionally, using Medicaid/receiving a tubal ligation for free was associated with marginally higher odds of desire for reversal (aOR = 1.92, <i>p</i> = 0.070, CIs: 0.95-3.91). Consistent with prior research, we found higher odds in the desire for reversal among those who received a tubal ligation for reasons other than ending childbearing and for non-Hispanic Black respondents, and lower odds for those with a history of unwanted pregnancy. <b><i>Conclusions:</i></b> The desire for sterilization reversal is similarly high among rural and urban women. However, aspects of the care visit did matter. To prevent sterilization procedures, people later want reversed; improvements in counseling are warranted across sites. At the same time, attention is needed to address structural barriers that limit contraceptive options.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1282-1289"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Yeast Infections and Antifungal Use in the First Trimester of Pregnancy: Findings from the Birth Defects Study to Evaluate Pregnancy exposureS, 2014-2019.","authors":"Eleni A Papadopoulos, Meredith M Howley, Sarah C Fisher, Martha M Werler, Paul A Romitti, Marilyn L Browne","doi":"10.1177/15409996251363394","DOIUrl":"10.1177/15409996251363394","url":null,"abstract":"<p><p><b><i>Background:</i></b> Yeast infections are common during pregnancy. Understanding their current prevalence and corresponding treatments during pregnancy is important. We used data from a U.S. population-based retrospective study of recently pregnant people to describe patterns of first trimester maternal yeast infections and antifungal use. <b><i>Materials and Methods:</i></b> Using a cohort of control participants from the Birth Defects Study to Evaluate Pregnancy exposureS, self-reports of first trimester yeast infections and antifungal use were collected via computer-assisted telephone interviews for births during 2014-2019. We described maternal characteristics and examined the prevalence of yeast infections and antifungal use overall and by study site and birth year. Tests for trend were used to evaluate changes over the study period. <b><i>Results:</i></b> After exclusions, there were 1,524 control participants included in our sample. First trimester yeast infections (9.8%) and antifungal use (8.6%) were common. More participants reported prescription (52.7%) than over-the-counter (45.0%) antifungals; most users reported a topical antifungal (72.5%). Prevalence of yeast infections and antifungal use increased modestly, but nonsignificantly, over the study period, ranging from 7.8% to 10.9% for yeast infections and 7.2% to 9.8% for antifungal use. Prevalence of topical and over-the-counter antifungals significantly increased over the study period; use of oral and prescription antifungals modestly decreased. <b><i>Conclusions:</i></b> In our cohort, first trimester yeast infections and antifungal use were relatively common and modestly increased throughout the study period, although this trend was not significant. We observed significant increases for topical and over-the-counter antifungals. Additional research is needed to investigate the reasons behind these prevalence changes.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1232-1239"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Contraceptive Counseling Quality and Contraceptive Use in a National Survey of Women Veterans.","authors":"Samantha K Benson, Siobhan Mahorter, Xinhua Zhao, Eleanor Bimla Schwarz, Sonya Borrero, Lisa S Callegari","doi":"10.1177/15409996251360153","DOIUrl":"10.1177/15409996251360153","url":null,"abstract":"<p><p><b><i>Background:</i></b> Contraceptive counseling quality is associated with trust in providers, method satisfaction, and method continuation. Little is known, however, about associations between counseling quality and method choice, particularly for methods requiring a high level of involvement of providers to initiate and stop the method. <b><i>Objective(s):</i></b> Investigate associations between experiences of high- or low-quality counseling and contraceptive method type. <b><i>Research Design:</i></b> We analyzed data from a national survey of women veterans ages 18-44 receiving care at the Veterans Health Administration (VA). Among participants who received contraceptive services at VA in the past year (<i>n</i> = 358), counseling quality was assessed with six Likert-scale items capturing key elements of patient-centered care. We explored two independent counseling quality variables: (1) high-quality (strongly agree on all items) versus all other responses and (2) low-quality (neutral/disagree/strongly disagree on ≥4 items) versus all other responses. Contraceptive methods were categorized based on the level of provider involvement required for initiation and discontinuation: long-acting reversible contraceptive (LARC) procedures, prescription methods, and those that require no provider involvement. We examined associations between quality and method type used using logistic regression models, controlling for potential confounding covariates. <b><i>Results:</i></b> Veterans reporting high-quality counseling were more likely (aOR: 1.95; 95% CI: 1.09, 3.48), and those reporting low-quality counseling were less likely (aOR: 0.12; 95% CI: 0.02, 0.90), to have undergone LARC placement. Veterans reporting low-quality counseling were more likely to have used a method that required no provider involvement (aOR: 2.71; 95% CI: 1.26, 5.83). <b><i>Conclusions:</i></b> High-quality contraceptive counseling is associated with use of LARC methods, while low-quality counseling is associated with use of contraceptives that require no provider involvement.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1257-1264"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}