Higher Contraceptive Knowledge Not Associated with More Effective Method Use in a High-Risk Minority Population at an Urban Title X-Funded Teen Services Clinic Open Access

Abstract

Objectives:

The goal of this secondary analysis was to determine if contraceptive knowledge was associated with contraceptive method use in a high-risk African-American population at an urban Title X-funded teen clinic.

Methods:

We recruited females aged 14-19 years old from an urban teen clinic from April-September 2012 and asked them to complete a cross-sectional survey to assess contraceptive use. Questions assessed last birth control method (BCM) used, contraceptive attitudes and knowledge, and factors considered when choosing the last BCM. Logistic regression was used to analyze the data in SAS 9.4.

Results:

Of 350 participants, 258 had ever used contraception. Compared to those who had used a less effective or no method as their last BCM, those who had used a long-acting reversible contraceptive (LARC) had similar odds of having higher contraceptive knowledge (OR=1.04, 0.36-3.03), while those who had used the pill, injectable, ring, or patch had decreased odds of having higher knowledge (OR=0.40, 0.22-0.74) when controlling for age, education, pregnancy history, and previous clinic visits. Reasons cited as important in contraception decisions were efficacy at preventing pregnancy (63%), partner acceptability (25%), method accessibility and ease of use (42%), and ability to induce amenorrhea (37%).

Conclusions:

Higher contraceptive knowledge was not associated with LARC use in this population of minority adolescents at high risk for unintended pregnancy. While accurate knowledge of method efficacy may be one important factor for providers to address with adolescents, counseling approaches that aim to elicit and respond to patient values and preferences when selecting a contraceptive method may help to improve correct and consistent contraceptive use.

Table of Contents

Table of Contents

Introduction………………………………………………………………………………………...1

Methods…………………………………………………………………………………………….4

Results………………………………………………………………………………………....…...6

Discussion………………………………………………………………………………………...10

Bibliography...……………………………………………………………………………………16

Table 1……………………………………………………………………………………………19

Table 2……………………………………………………………………………………………20

Table 3……………………………………………………………………………………………21

Table 4……………………………………………………………………………………………22

Table 5...……………………………………………………………………………………….....23

Appendix………………………..………………………………………………………………...24

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology Health Sciences, Obstetrics and Gynecology
Keyword	disparities in contraceptive use teen contraception contraceptive knowledge adolescent contraception long-acting reversible contraceptives (LARC)
Committee Chair / Thesis Advisor	Rochat, Roger, Emory University
Committee Members	Kottke, Melissa, Emory University
Partnering Agencies	CDC

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