Do Knowledge and Attitudes Regarding Intrauterine Devices Predict Interest in Their Use?

Gómez, Anu Manchikanti; Hartofelis, E. Cameron; Finlayson, Sara; Clark, Jeffery J.

doi:10.1016/j.whi.2015.03.011

Cited by 34 publications

(29 citation statements)

References 36 publications

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“…Additionally, awareness of access to LARC was limited too, with three quarters not knowing that IUDs and implants are readily available to them on campus. Results are consistent with an increasing body of research describing young women’s general lack of LARC knowledge, misperceptions about IUD and implant side effects and ineligibility, and desire for more information on highly effective methods [14,15,17,19,20]. Our study expands this body of work by: 1) using a multi-dimensional, formal measurement approach that addresses knowledge of and barriers to LARC operating across multiple levels of women’s environments; 2) focusing on both IUDs and implants; 3) employing a large sample of both adolescent and young adult women; and 4) focusing on the college setting–an understudied but important context in population-based family planning research given the scope of reproductive aged women enrolled in higher education programs and the high rates of unintended pregnancy in this age demographic.…”

Section: Discussionsupporting

confidence: 83%

“…Several top-ranking reasons reflected women’s preferences , including not wanting a foreign object in body and preference for a “controllable” method. These same barriers were found to predict IUD acceptability and interest among 382 young adults in another recent U.S. web-based LARC survey [20]. Related work suggests that patient-centered models of reproductive health care and contraceptive decision-making are urgently needed [24,27–31].…”

Section: Discussionmentioning

confidence: 68%

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“I don't know enough to feel comfortable using them:” Women's knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus

et al. 2016

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Objective To assess multiple dimensions of long acting reversible contraception (LARC) knowledge and perceived multi-level barriers to LARC use among a sample of college women. Study Design We conducted an internet-based study of 1,982 female undergraduates at a large mid-western university. Our 55-item survey used a multi-level framework to measure young women’s understanding of, experiences with intrauterine devices (IUD) and implants and their perceived barriers to LARC at individual, health systems, and community levels. The survey included a 20-item knowledge scale. We estimated and compared LARC knowledge scores and barriers using descriptive, bivariate, and linear regression statistics. Results Few college women had used (5%) or heard of (22%) LARC, and most self-reported “little” or “no” knowledge of IUDs (79%) and implants (88%). Women answered 50% of LARC knowledge items correctly (mean 10.4, range 0–20), and scores differed across sociodemographic groups (p-values<0.04). Factors associated with scores in multivariable models included race/ethnicity, program year, sorority participation, religious affiliation and service attendance, employment status, sexual orientation, and contraceptive history. Perceived barriers to IUDs included: not wanting a foreign object in body (44%); not knowing enough about the method (42%); preferring a “controllable” method (42%); cost (27%); and not being in a long-term relationship (23%). Implant results were similar. “Not knowing enough” was women’s primary reason for IUD (18%) and implant (22%) nonuse. Conclusion Lack of knowledge (both perceived and actual) was the most common barrier among many perceived individual, systems, and community-level factors precluding these college women’s LARC use. Findings can inform innovative, multi-level interventions to improve understanding, acceptability, and uptake of LARC on campuses.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 68%

“I don't know enough to feel comfortable using them:” Women's knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus

et al. 2016

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“…Objective contraceptive knowledge was measured based on a series of true/false statements assessing understanding of correct use, effectiveness and other facts about birth control pills, condoms, injectable contraception, and IUDs. These questions have been used in several other analyses of men's and women's contraceptive awareness and knowledge [14][15][16]22,24]. Four summary knowledge scores were calculated for each method based on the number of correct answers to these questions.…”

Section: Methodsmentioning

confidence: 99%

“…Research and interventions focused on IUDs have nearly exclusively focused on women [17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Young men’s awareness and knowledge of intrauterine devices in the United States

Marshall

Gómez

2015

Contraception

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“…Obstacles to obtaining LARC include user awareness [9], medical provider knowledge and skill [10], and financial burdens [2]. Individuals with limited financial resources are particularly sensitive to out-of-pocket costs.…”

Section: Introductionmentioning

confidence: 99%

Changes in uptake and cost of long-acting reversible contraceptive devices following the introduction of a new low-cost levonorgestrel IUD in Utah's Title X clinics: a retrospective review

et al. 2018

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Objective: The objective was to assess changes in long-acting reversible contraceptive (LARC) method uptake at Utah’s Title X clinics before and after introduction of a new, low-cost levonorgestrel (LNG) 52 mg IUD (Liletta®). Study design: We conducted a retrospective medical record review of LARC visits occurring at seven Title-X family planning clinics in Utah before the introduction of the low-cost LNG IUD (preintroduction period: 01/01/2014–04/30/2015) and after (postintroduction period: 05/01/2015–03/31/2016). We ran segmented, interrupted time series ordinary least squares regression models using Newey–West standard errors to assess both the change in numbers of women initiating any LARC method and the average payment amount per LARC method. We evaluated both the low-cost LNG IUD and all LARC methods. Results: At the outset of preintroduction period, there were 29.2 [95% confidence interval (CI): 20.1–38.4] monthly LNG IUD insertions. Immediately postintroduction, there was a significant level of increase of 14.4 LNG IUD insertions the first month (95% CI: 2.0–26.8) followed by a significant trend increase each month of 2.4 additional LNG IUD insertions (95% CI: 0.32–4.47). Postintroduction, there was a significant level of remitted-payment decrease from all sources of −$240.43 per LNG IUD (95% CI: −311.02 to 168.87) followed by a significant monthly trend decrease of −$23.01 per LNG IUD (95% CI: −32.02 to −13.98). There were minimal changes in uptake and payment of other LARC methods following the introduction of the low-cost LNG IUD. Conclusions: Following introduction of a low-cost LNG IUD at Title X clinics, LNG IUD initiation increased and average payment for the method decreased. Implications: Reducing the cost of LARC methods, both to clinics and to patients, is essential to expanding access. Additional efforts to develop and provide access to low-cost copper IUDs and subdermal implants as well as novel LARC methods should be continued.

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Do Knowledge and Attitudes Regarding Intrauterine Devices Predict Interest in Their Use?

Abstract: Background: Increasing use of intrauterine devices (IUDs) is seen as a promising strategy to

Cited by 34 publications

References 36 publications

“I don't know enough to feel comfortable using them:” Women's knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus

“I don't know enough to feel comfortable using them:” Women's knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus

Young men’s awareness and knowledge of intrauterine devices in the United States

Changes in uptake and cost of long-acting reversible contraceptive devices following the introduction of a new low-cost levonorgestrel IUD in Utah's Title X clinics: a retrospective review

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