Long-acting reversible contraception use among adolescents is low, but increasing it could lower adolescent pregnancy rates, according to study results.
The qualitative exploratory interview study of 28 physicians (nine family physicians, 10 pediatricians and nine obstetrician-gynecologists) was based on an implementation science theoretical framework. Researchers used the Capability, Opportunity, Motivation-Behavior system to interpret the results.
They found that many physicians did not counsel adolescent patients about intrauterine devices (IUDs) because they were trained not to offer IUDs to patients without children. They also found that different types of physicians offered different levels of care; pediatricians offered the least contraception options. IUDs also are costly, which physicians attribute to the lack of use.
Researchers also found that physicians are worried that an IUD would lead to an adolescent’s skewed risk for pregnancy and STDs.
Only two sites in the study had implantable contraception, according to the researchers. They said few physicians gave the option because of their own lack of knowledge and access.
“Knowledge, skills, clinical environment, and physician attitudes, all influence the likelihood a physician will counsel or insert long-acting reversible contraception for adolescents,” researchers said. “Interventions to increase adolescents’ access long-acting reversible contraception in primary care must be tailored to individual clinical practice sites and practicing physicians, the methods must be made more affordable, and residency programs should offer up-to-date, evidence based teaching.”
Disclosure: The study was supported by grants from NIH, NCRR and NIH Roadmap for Medical Research.