Missed Opportunities for Pregnancy Prevention Among Insured Adolescents

Kharbanda, Elyse O.; Stuck, Logan; Molitor, Beth A.

doi:10.1001/jamapediatrics.2014.2809

Cited by 14 publications

(10 citation statements)

References 11 publications

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“…Using data from the National Survey of Family Growth, we calculated the percent of teens 15-19 who had ever had sex by race to develop race-specific estimates. This percentage is multiplied by the number teens (15)(16)(17)(18)(19) of each race to estimate the number of sexually active teens by race. The number of sexually active teenagers in the United States is the denominator and the pregnancy rate is the numerator of the race specific estimates.…”

Section: Methodsmentioning

confidence: 99%

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

Goodman

Onwumere

Milam

et al. 2017

Obstetrical &Amp; Gynecological Survey

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CONDENSATIONBlack-white health disparities in the rate of unintended pregnancies can be reduced by providing education, reducing access barriers, and providing contraception at no cost. 2009, 2010, and 2011. We estimated an absolute measure (rate difference (RD)) and a relative measure (rate ratio (RR)) to examine Black-White disparities in the rates of unintended pregnancy.Results: While national rates of unintended pregnancy are decreasing, racial disparities in these rates persist. The Black-White rate difference dropped from 158.5 per 1,000 in 2008 to 120.1 per 1,000 in 2011; however, the relative ratio disparity decreased only from 2.6 to 2.5, suggesting that Black sexually active teens in the U.S.have 2.5 times the rate of unintended pregnancy as White teenagers. In the CHOICE Project, there was a decreasing trend in racial disparities in unintended pregnancy rates Draft 12/6/17 Unintended Pregnancies: Reducing Health Disparities Page | 4 among sexually active teens (age 15-19); RR=3.7), 2010 RR=1.2) and 2013-2014 (RD=-1.5; RR=1.0). Conclusions:When barriers to cost, access, and knowledge were removed, such as in the Contraceptive CHOICE Project, Black-White disparities in unintended pregnancy rates among sexually active teens are reduced on both absolute and relative scales.The rate of unintended pregnancy was almost equal between Black and White women compared to large Black-White disparities on the national level. Word Count: 343Draft 12/6/17

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Section: Methodsmentioning

confidence: 99%

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

Goodman

Onwumere

Milam

et al. 2017

Obstetrical &Amp; Gynecological Survey

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“…12,13 Even for those AYAs who attended an annual well visit, reproductive health care is not routinely addressed. 14 Given the significant proportion of AYAs who do not attend annual well visits, researchers have studied the offering of health prevention services in nonprimary care settings. [15][16][17][18] Studies revealed that adolescents felt that providing contraceptive counseling and initiation in the emergency department 19,20 and in the inpatient setting 21 were acceptable.…”

mentioning

confidence: 99%

Contraception for Adolescents and Young Adults in the Inpatient Setting: The Providers’ Perspective

Goldstein

Carlson

Halpern‐Felsher

2018

Hospital Pediatrics

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“…A recent study in Minnesota focused on missed opportunities to provide contraceptive counseling, which were defined as preventive, acute, or follow-up visits with a physician, nurse practitioner, or physician’s assistant in pediatrics, family practice, or obstetrics and gynecology in the 12 months prior to pregnancy. 22 The study focused on adolescents aged 15–19.9 years with continuous health insurance coverage in the study period and found a mean of 2.7 missed opportunities per teenage pregnancy. Of these visits, sexual activity was not documented in 57%, and reproductive health counseling was not documented in 47%.…”

Section: Discussionmentioning

confidence: 99%

Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study

et al. 2017

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Objectives:Data suggest that adolescents in the United States receive inadequate contraceptive counseling. This study sought to determine factors affecting pediatricians’ discussion of contraception with adolescent patients, with a specific focus on long-acting reversible contraception—implantable contraception and intrauterine devices.Methods:A cross-sectional survey was sent via email to a convenience sample of pediatric residents and pediatric primary care providers in Western Pennsylvania. Self-reported contraceptive counseling and prescribing practices in response to clinical vignettes were assessed.Results:Of potential participants (287), 88 (31%) responded. Younger providers and providers who had received contraceptive training were significantly more likely to discuss long-acting reversible contraception methods. Discussion of contraceptive methods also varied by both the age and the sexual history of the patient.Conclusion:Variation in contraceptive counseling potentially results in missed opportunities to counsel about and provide the most effective contraceptive methods. More uniform, universal provider training might alleviate some of these inconsistencies.

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Missed Opportunities for Pregnancy Prevention Among Insured Adolescents

Abstract: Our data highlight the need for primary care professionals to review health behaviors and pregnancy risk at all adolescent encounters.

Cited by 14 publications

References 11 publications

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

Reducing Health Disparities by Removing Cost, Access, and Knowledge Barriers

Contraception for Adolescents and Young Adults in the Inpatient Setting: The Providers’ Perspective

Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study

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