Counseling and provision of long-acting reversible contraception in the US: national survey of nurse practitioners.

Objective: Nurse practitioners (NPs) provide frontline care in women's health, including contraception, an essential preventive service. Their importance for contraceptive care will grow, with healthcare reforms focused on affordable primary care. This study assessed practice and training needs to prepare NPs to offer high-efficacy contraceptives - intrauterine devices (IUDs) and implants.

Access to levonorgestrel emergency contraception: science versus federal politics.

Past US FDA decisions about emergency contraception (EC) have been subject to undue political influence, and last year's barring of over-the-counter access to Plan B One-Step(®) for those under the age of 17 years is no exception. The US Department of Health and Human Services cited insufficient data on EC use for females aged 11-12 years. These youngest adolescents, however, rarely need EC: data from California (USA) show that in 2009, fewer than one in 10,000 females under the age of 13 years received EC.

Evaluation of e-mail contact to conduct follow-up among adolescent women participating in a longitudinal cohort study of contraceptive use.

Background: The purpose of this study was to determine whether e-mail contact is a viable method for gathering information from adolescent women about contraceptive use.

Study Design: Adolescent women initiating contraception followed in a prospective longitudinal cohort study and who had access to the Internet were randomized to the control or intervention arm and were contacted at 3, 6 and 12 months after enrollment. The control arm completed follow-up surveys in-person or by telephone.

With pills, patches, rings, and shots: who still uses condoms? A longitudinal cohort study.

Purpose: To describe women's condom use patterns over time and assess predictors of dual method use 12 months after initiating hormonal contraceptives.

Methods: We conducted a prospective cohort study among women aged 15-24 years initiating oral contraceptive pills, patch, ring, or depot medroxyprogesterone and attending public family planning clinics. Participants completed questionnaires at baseline and 3, 6, and 12 months after enrollment.

Evidence-based IUD practice: family physicians and obstetrician-gynecologists.

Background And Objectives: Family physicians and obstetrician-gynecologists provide much of contraceptive care in the United States and have a shared goal in preventing unintended pregnancy among patients. We assessed their competency to offer women contraceptives of the highest efficacy levels.

Methods: We conducted a national probability survey of family physicians and obstetrician-gynecologists (n=1,192).

An over-the-counter simulation study of a single-tablet emergency contraceptive in young females.

Objectives: To evaluate use of a single-tablet (levonorgestrel 1.5 mg) emergency contraceptive administered to young females under simulated over-the-counter conditions. Secondary objectives were to assess repeat use, pregnancy, and adverse events.

Contraceptive discontinuation and repeat unintended pregnancy within 1 year after an abortion.

Background: We examined 12-month hormonal contraceptive continuation and pregnancy rates by abortion history.

Study Design: Women who wanted to avoid pregnancy for at least 1 year were recruited at four San Francisco Bay area family planning clinics on regular service days and on abortion care days. Participants completed baseline and follow-up questionnaires.

One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives.

Objective: To assess contraceptive discontinuation, switching, factors associated with method discontinuation, and pregnancy among women initiating hormonal contraceptives.

Methods: This was a 12-month longitudinal cohort study of adolescent girls and women (n=1,387) aged 15 to 24 years attending public family planning clinics who did not desire pregnancy for at least 1 year and selected to initiate the patch, ring, depot medroxyprogesterone acetate, or pills. Participants completed follow-up assessments at 3, 6, and 12 months after baseline.

Impact of an intervention to improve contraceptive use through follow-up phone calls to female adolescent clinic patients.

Context: Adolescent females often have questions or concerns about their contraceptive methods, and they may discontinue use if these questions are not answered. Little evidence exists on whether follow-up phone calls to address young women's concerns can help sustain contraceptive use.

Methods: Between 2005 and 2007, a total of 805 females aged 14-18 attending a reproductive health clinic in San Francisco were randomly assigned to receive either regular clinic services or regular clinic services plus nine follow-up phone calls over 12 months.

Hormonal contraceptive method choice among young, low-income women: how important is the provider?

Objectives: Several new methods are available, but we know little about successful integration of contraceptive technologies into services. We investigated provider factors associated with the initiation of new hormonal methods among women at high risk of unintended pregnancy.

Methods: This cohort study enrolled 1387 women aged 15-24 starting hormonal contraception (vaginal ring, transdermal patch, oral contraceptive, or injectable) at four family planning clinics in low-income communities.

Attitudes and beliefs about the intrauterine device among teenagers and young women.

Background: Little is known about attitudes and beliefs among teenagers and young women about the intrauterine device (IUD).

Study Design: We surveyed 252 women, ages 14-27 years, presenting for appointments at an urban family planning clinic about demographics, sexual and birth control history, and opinions about the IUD.

Results: Fifty-five percent had not heard of the IUD.

Should providers give women advance provision of emergency contraceptive pills? A cost-effectiveness analysis.

Purpose: We sought to determine the potential effect and cost-effectiveness of different means of accessing emergency contraceptive pills (ECP) on unintended pregnancy rates in sexually active women.

Methods: We used a computer simulation model to compare the effects of advance provision, on-demand provision, and no use of ECP on unintended pregnancies and costs of care in three hypothetical cohorts of 1 million sexually active women. Data on effectiveness of ECP from the single-use clinical trials, and costs from Medi-Cal, California's Medicaid program were used for the model.

Abstinence and teenagers: prevention counseling practices of health care providers serving high-risk patients in the United States.

Context: Abstinence-only education has had little demonstrable impact on teenagers' sexual behaviors, despite significant policy and funding efforts. Given the struggle over resources to improve teenagers' reproductive health outcomes, the views of clinicians serving teenagers at high risk for unintended pregnancy and STDs merit particular attention.

Methods: In 2005, a qualitative study with 31 clinicians serving low-income, at-risk patients was conducted.

"I wouldn't be this firm if I didn't care": preventive clinical counseling for reproductive health.

Objective: This qualitative study of health care clinicians serving women at heightened risk of sexually transmitted infections and unintended pregnancy was undertaken to explore concepts underlying reproductive health counseling messages in clinical encounters.

Methods: In-depth interviews were conducted with 31 clinicians, including physicians and advanced practice nurses serving primarily low-income patients in high-risk communities throughout the U.S.

Contraceptive decision-making in sexual relationships: young men's experiences, attitudes and values.

Much attention has been focused on efforts to reduce unintended pregnancy by improving contraceptive use among high-risk women; however, there is limited information to guide interventions to engage young men in contraceptive decision-making. We conducted focus groups of young men, aged 19-26, from diverse racial backgrounds from low-income communities in the San Francisco Bay Area to examine social norms about sexual relationships and how they impact on contraceptive use. The data were analysed using content analysis.

Attitudes toward the vaginal ring and transdermal patch among adolescents and young women.

Purpose: The vaginal ring and the transdermal patch offer important contraceptive options for women at high risk for unintended pregnancy. Little is known about what adolescents and young women think about these methods and why use of the ring has been relatively low compared with the patch. We sought to examine young women's attitudes and perceptions about the ring and the patch to better understand the relationship between perceptions of these methods and decisions to use them.

Barriers to adolescents' getting emergency contraception through pharmacy access in California: differences by language and region.

Context: In California, emergency contraception is available without a prescription to females younger than 18 through pharmacy access. Timely access to the method is critical to reduce the rate of unintended pregnancy among adolescents, particularly Latinas.

Methods: In 2005-2006, researchers posing as English- and Spanish-speaking females-who said they either were 15 and had had unprotected intercourse last night or were 18 and had had unprotected sex four days ago-called 115 pharmacy-access pharmacies in California.

Adolescent experiences with the vaginal ring.

Purpose: To understand racial/ethnic minority adolescent females' experiences with the vaginal ring.

Methods: We conducted in-depth interviews with a clinic-based sample of 32 young women aged 15-24 years who had used the vaginal ring.

Results: Qualitative analysis using grounded theory revealed that adolescents undergo a multi-stage process when trying the ring and adopting ring use.

Adolescent and young women's experience with the vaginal ring and oral contraceptive pills.

Study Objective: To compare acceptability of the vaginal contraceptive ring to that of oral contraceptive pills.

Design: Randomized, cross-over, 6-month study.

Setting: Urban family planning clinic for young low-income patients.

Pharmacy access to emergency contraception: Perspectives of pharmacists at a chain pharmacy in San Francisco.

Objective: To assess pharmacists' perception of their role in dispensing emergency contraception (EC) in San Francisco.

Design: Cross-sectional study.

Setting: Community chain pharmacies in San Francisco during summer 2002.

Predictors of incident herpes simplex virus type 2 infections in young women at risk for unintended pregnancy in San Francisco.

Background: Young women receiving family planning services are at risk for both unintended pregnancy and herpes simplex virus type 2 (HSV-2) infection.

Methods: We performed a secondary analysis using data from a previously published randomized controlled trial evaluating access to emergency contraception on reproductive health outcomes. Women aged 15 to 24 years were recruited from two Planned Parenthood clinics and two community health clinics in San Francisco.

Beyond access: acceptability, use and nonuse of emergency contraception among young women.

Objective: This study was undertaken to assess the acceptability of levonorgestrel emergency contraception (EC).

Study Design: We examined attitudes and use patterns among 1950 women in a randomized trial evaluating access to EC through advance provision, pharmacies, or clinics.

Results: Most women considered EC to be safe (92%) and effective (98%).

Pharmacokinetics of single-dose levonorgestrel in adolescents.

Purpose: The purpose of this study is to compare the pharmacokinetics of levonorgestrel, a drug used for emergency contraception between female adolescents and adults.

Methods: Twenty-two female subjects, aged 13-16 years, received a single 0.75-mg dose of the drug.