Long-Acting Reversible Contraception for Adolescents: A Review of Practices to Support Better Communication, Counseling, and Adherence.

IF 1.7 Q2 PEDIATRICS Adolescent Health Medicine and Therapeutics Pub Date : 2023-05-05 eCollection Date: 2023-01-01 DOI:10.2147/AHMT.S374268
Julia C Durante, Jessica Sims, Jason Jarin, Melanie A Gold, Sarah E Messiah, Jenny K R Francis
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Abstract

Long-acting reversible contraception (LARC) methods, including levonorgestrel and copper intrauterine devices (IUDs) and the subdermal contraceptive implant, are the most effective reversible forms of contraception and thus are an important aspect of adolescent pregnancy prevention. While LARC efficacy, safety, and appropriateness are supported by major medical organizations and usage rates are increasing, overall LARC uptake among United States (US) adolescents remains lower than uptake of short-acting contraceptive methods. A better understanding of the barriers affecting adolescent LARC uptake and reasons for discontinuation could help facilitate effective communication. For example, learning how to improve adolescent-centered communication, shared decision-making, and motivational counseling strategies may be the first step to improving utilization rates. This narrative review includes three sections. First, this review will describe the history, mechanisms of action, and epidemiology of adolescent LARC use in the US and globally. Next, this review will describe key factors influencing adolescent LARC uptake, reasons for discontinuation, and multilevel barriers specific to adolescent LARC use. Finally, this review will characterize communication techniques and LARC counseling strategies for adolescents in the context of a reproductive justice approach set in the health belief model framework. The distinction between moving away from a presumptive counseling approach towards an adolescent-centered, shared decision-making approach to encourage parent-adolescent sexual health communication to lay the foundation of empowering adolescent reproductive autonomy should be the underpinning of all effective reproductive communication strategies.

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青少年长效可逆避孕:支持更好沟通、咨询和坚持的实践综述。
长效可逆避孕(LARC)方法,包括左炔诺孕酮和铜宫内节育器(IUD)以及皮下避孕植入物,是最有效的可逆避孕形式,因此是预防青少年怀孕的一个重要方面。虽然LARC的有效性、安全性和适当性得到了主要医疗组织的支持,使用率也在提高,但美国青少年对LARC的总体接受率仍低于短效避孕方法的接受率。更好地了解影响青少年LARC吸收的障碍和中断的原因有助于促进有效的沟通。例如,学习如何改善以青少年为中心的沟通、共享决策和动机咨询策略可能是提高利用率的第一步。这篇叙述性综述包括三个部分。首先,这篇综述将描述美国和全球青少年LARC使用的历史、作用机制和流行病学。接下来,这篇综述将描述影响青少年LARC摄取的关键因素、停用原因以及青少年LARC使用的多层次障碍。最后,本综述将在健康信念模型框架中设定的生殖正义方法的背景下,描述青少年的沟通技巧和LARC咨询策略。从假定的咨询方法转向以青少年为中心的共同决策方法,以鼓励父母与青少年的性健康沟通,为增强青少年生殖自主性奠定基础,这两者之间的区别应该是所有有效生殖沟通战略的基础。
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来源期刊
自引率
0.00%
发文量
13
审稿时长
16 weeks
期刊介绍: Adolescent Health, Medicine and Therapeutics is an international, peer reviewed, open access journal focusing on health, pathology, and treatment issues specific to the adolescent age group, including health issues affecting young people with cancer. Original research, reports, editorials, reviews, commentaries and adolescent-focused clinical trial design are welcomed. All aspects of health maintenance, preventative measures, disease treatment interventions, studies investigating the poor outcomes for some treatments in this group of patients, and the challenges when transitioning from adolescent to adult care are addressed within the journal. Practitioners from all disciplines are invited to submit their work as well as health care researchers and patient support groups. Areas covered include: Physical and mental development in the adolescent period, Behavioral issues, Pathologies and treatment interventions specific to this age group, Prevalence and incidence studies, Diet and nutrition, Specific drug handling, efficacy, and safety issues, Drug development programs, Outcome studies, patient satisfaction, compliance, and adherence, Patient and health education programs and studies.
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