Intimate partner violence and delays in obtaining contraception among young people in California and Texas.

Objective: Experiencing intimate partner violence (IPV) can negatively impact young people's reproductive autonomy, including making it more challenging to get contraception. This study examined the association between IPV and delays in obtaining contraception in a sample of young women from California and Texas.

Study Design: The data are from a supplementary study to a cluster randomized controlled trial conducted with young people sexually-active within the past year recruited at 29 community colleges during the COVID-19 pandemic (May 2020-May 2023).

Measuring contraceptive agency in the community.

Objectives: This study aimed to evaluate the Contraceptive Agency Scale (CAS), developed as a clinic-based measure, within a community population and to assess how agency varied by demographic and reproductive characteristics.

Study Design: We conducted a cross-sectional survey of 1917 participants aged 15-45 years living in Oregon in 2023. Participants responded to the 7-item CAS, comprised items relating to active decision-making, freedom from coercion, and nonjudgmental care during their last health care visit involving contraceptive counseling.

Delayed pregnancy disclosure, attributed social factors and implications for antenatal care initiation: a qualitative study among Ugandan women and their partners.

Background: Pregnant women in Uganda access antenatal care later in pregnancy than recommended. One potential factor influencing timing of antenatal care initiation is delayed pregnancy disclosure affecting the social support needed to facilitate care-seeking. However, data exploring women's decisions to disclose their pregnancy and the consequences for antenatal care-seeking are limited.

Perceived Barriers to Care for Urinary Tract Infections in Emerging Adulthood.

Background: Urinary tract infections (UTIs) are common in emerging adulthood, yet barriers to care are not well understood.

Objective: To examine perceived barriers to UTI care among emerging adults, analyzing differences by social determinants of health.

Design: Supplementary study to a cluster randomized controlled trial in 29 community colleges in California and Texas.

A qualitative study of abortion decision-making trajectories among pregnant women at their first antenatal care visit in Kampala, Uganda.

Background: In Uganda, only about half of women who want to avoid pregnancy are using modern contraceptives, leading to high numbers of unintended pregnancies and elevated maternal and neonatal morbidity and mortality. In this study, we aimed to learn more about women's abortion decision-making before continuing to carry a pregnancy.

Methods: We utilised a qualitative study design and interviewed 31 purposively selected single and partnered pregnant women aged ≥18 years at their first antenatal care visit at Kawempe National Referral Hospital in Kampala, Uganda.

"I am putting my fear on them subconsciously": a qualitative study of contraceptive care in the context of abortion bans in the U.S.

Background: Since the Dobbs vs. Jackson Women's Health Organization decision in June 2022, providers throughout the U.S.

Use of telemedicine to obtain contraception among young adults: Inequities by health insurance.

Objectives: The objective of this study was to describe the use of telemedicine for contraception in a sample of young adults and examine differences by health insurance coverage.

Study Design: We analyzed survey data collected from May 2020 to July 2022 from individuals at risk of pregnancy aged 18 to 29 recruited at 29 community colleges in California and Texas. We used multivariable mixed-effects logistic regression models with random effects for site and individual to compare the use of telemedicine to obtain contraception by insurance status, sociodemographic characteristics, and state.

Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults.

Symptoms of mental distress increased sharply during the COVID-19 pandemic, especially among older adolescents and young adults. Mental health distress may make it more challenging for young people to seek other needed health care, including contraception. This study explored the association of symptoms of depression, anxiety, and stress with delays in getting a contraceptive method or prescription.

Measuring a Critical Component of Contraceptive Decision Making: The Contraceptive Concerns and Beliefs Scale.

Introduction: Concerns about safety and side effects from contraceptives are widespread and related to reluctance to use them. Measuring these concerns is an essential component of understanding contraceptive decision-making and guiding contraceptive and interpregnancy clinical care.

Methods: We used qualitative research and item response theory to develop and test a psychometric instrument to measure contraceptive concerns and beliefs.

Concern that contraception affects future fertility: How common is this concern among young people and does it stop them from using contraception?

Objectives: This study examines the concern that contraception affects future fertility among community college students and its association with contraceptive use.

Study Design: We used baseline data from a randomized controlled trial with 2060 community college students assigned female at birth. We used mixed-effects multivariate logistic regression adjusted for clustered data to assess sociodemographic factors associated with concerns about contraception affecting future fertility and to test the association between this concern and contraceptive use.

Use of preferred contraceptive method among young adults in Texas and California: A comparison by state and insurance coverage.

Background: Young people's ability to use their preferred contraceptive method is an indicator of reproductive autonomy and healthcare access. State policies can hinder or facilitate access to a preferred contraceptive method.

Objective: This study compared use of preferred contraceptive method in Texas and California, states with contrasting health policy contexts that impact health insurance coverage and access to subsidized family planning services.

Contraceptive preferences and adoption following female genital fistula surgery in Uganda: a mixed-methods study.

Background: Female genital fistula, largely caused by prolonged obstructed labour, is treated by surgical repair. Preventing pregnancy for a minimum period post-repair is recommended to ensure adequate healing and optimize post-repair outcomes.

Methods: We examined contraceptive preferences and use among Ugandan fistula patients (n = 60) in the year following genital fistula surgery using mixed-methods.

"She should support me, she's my doctor:" Patient perceptions of agency in contraceptive decision-making in the clinical encounter in Northern California.

Introduction: Agency in contraceptive decision-making is an essential aspect of reproductive autonomy. We conducted qualitative research to investigate what agency means to patients seeking contraceptive care to inform the development of a validated measure of this construct.

Methodology: We held four focus group discussions and seven interviews with sexually-active individuals assigned female at birth, ages 16-29 years, recruited from reproductive health clinics in Northern California.

Educational Intervention Among Adolescents and Young Adults on Emergency Contraception Options.

Purpose: Emergency contraception (EC), the 'last chance' contraceptive method, has gained significance post-Roe, but most young people do not know their options.

Methods: We conducted an educational intervention on EC among 1,053 students aged 18-25 years. We assessed changes in knowledge of key aspects of EC using generalized estimating equations.

Effectiveness and efficacy rates of progestin-only pills: A comprehensive literature review.

Objectives: To synthesize published literature on POP effectiveness and efficacy.

Study Design: We searched PubMed Central, PubMed, and the Cochrane library through March 07, 2022. We included articles written in English reporting a Pearl Index or life table rate for pregnancy.

The role of informational support from women's social networks on antenatal care initiation: qualitative evidence from pregnant women in Uganda.

Background: Early and appropriate use of antenatal care services is critical for reducing maternal and neonatal mortality and morbidity. Yet most women in sub-Saharan Africa, including Uganda, do not seek antenatal care until later during pregnancy. This qualitative study explored pregnant women's reliance on social ties for information about initiation of antenatal care.

Agency in Contraceptive Decision-Making in Patient Care: a Psychometric Measure.

Background: Patient agency in contraceptive decision-making is an essential component of reproductive autonomy.

Objective: We aimed to develop a psychometrically robust measure of patient contraceptive agency in the clinic visit, as a measure does not yet exist.

Design: For scale development, we generated and field tested 54 questionnaire items, grounded in qualitative research.

Telehealth for Contraceptive Services During the COVID-19 Pandemic: Provider Perspectives.

Background: Telehealth use rapidly increased during the COVID-19 pandemic, including for contraceptive care (e.g., counseling and method provision).

Virtual Intrauterine Device Placement Training Improves Clinician Comfort.

Background And Objectives: Virtual intrauterine device (IUD) training options can improve clinician continuing education and patient IUD access. Our objective was to evaluate a virtual, hands-on IUD training for primary care clinicians.

Methods: Training sessions occurred via video conferencing and included didactic instruction on IUD eligibility, counseling, placement, and removal.

Perceived Access to Contraception via Telemedicine Among Young Adults: Inequities by Food and Housing Insecurity.

Background: Telemedicine expanded rapidly during the COVID-19 pandemic, including for contraceptive services. Data are needed to understand whether young people can access telemedicine for contraception, especially in underserved populations.

Objective: To compare young people's perceived access to telemedicine visits for contraception during the COVID-19 pandemic by food and housing insecurity.

Assessing differences in contraceptive provision through telemedicine among reproductive health providers during the COVID-19 pandemic in the United States.

Background: Providers faced challenges in maintaining patient access to contraceptive services and public health safety during the COVID-19 pandemic. Due to increased barriers to care, providers increasingly used telemedicine for contraceptive care, curbside services, mail-order pharmacies, and on-line or home delivery of contraceptive methods, including self-administration of subcutaneous depo medroxyprogesterone acetate (DMPA-SQ). To better understand how reproductive health providers adapted service provision during the pandemic, this study assessed clinical practice changes and strategies providers adopted throughout the United States to maintain contraceptive care, particularly when clinics closed on-site, and the challenges that remained in offering contraceptive services, especially to marginalized patient populations.

An Educational Intervention to Raise Awareness of Contraceptive Options Among Young People.

Young people in the United States know little about contraceptive options available to them, although method use is sensitive to individual preferences, and method switching is common. For young people to gain reproductive autonomy, a first step is to be aware of different contraceptives, including hormonal and nonhormonal methods. We tested whether an educational intervention delivered on community college campuses was effective in increasing contraceptive awareness.