Knowledge and Likelihood to Recommend Intrauterine Devices for Adolescents Among School-based Health Center Providers

• Published in: Journal of adolescent health Vol. 51; no. 4; pp. 319 - 324
• Main Authors: Kohn, Julia E., Ph.D, Hacker, Jordan G., M.P.H, Rousselle, Marissa A., M.P.H, Gold, Marji, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2012; Elsevier
• Subjects: Adolescent; Adolescents; Biological and medical sciences; Counseling; Environment. Living conditions; Female; Health; Health Care Surveys; Health Knowledge, Attitudes, Practice; Health participants; Health Personnel; Housing. Living conditions; Humans; Intrauterine Devices; IUDs and adolescents; Long-acting reversible contraceptives; Medical sciences; New York City; Obstetricians; Pediatrics; Pregnancy; Pregnancy in Adolescence - prevention & control; Provider attitudes toward IUDs; Provider knowledge of IUDs; Public health. Hygiene; Public health. Hygiene-occupational medicine; School based; School Health Services; School Nursing; School-based health center; Social Work; Social workers; New York City; Provider attitudes toward IUDs; IUDs and adolescents; School-based health center; Provider knowledge of IUDs; Intrauterine devices; Long-acting reversible contraceptives; Human; Health staff; Attitude; Contraception; Knowledge; In utero; School environment; Prevention; Health center; Pediatrician; Adolescent; Social worker; Public health; Nurse
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2011.12.024

Abstract Purpose The American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention recommend intrauterine devices (IUDs) as safe and highly effective contraceptives for adolescents. Nevertheless, many U.S. providers do not recommend or provide IUDs to adolescents—a population at high risk for unintended pregnancy. The purpose of this study was to identify barriers to IUD provision for adolescents. Methods A 36-item self-administered survey of knowledge and attitudes regarding IUDs was completed by 162 staff of New York City school-based health centers, including 69 clinicians (e.g., pediatricians and nurse practitioners) and 93 nonclinicians (e.g., social workers and health educators). Results Half (55%) of all respondents would be likely to recommend an IUD to a patient under age 20 years. Respondents were less likely to recommend an IUD for patients with history of recent STD (31%), remote pelvic inflammatory disease (37%), and patients not in a monogamous relationship (38%). Whereas 77% of respondents indicated that IUDs are safe for adolescents, 18% of those respondents would be unlikely to recommend an IUD to a patient under age 20 years. While 86% of respondents knew that IUDs can be used in nulliparous women, 25% of those respondents would be unlikely to recommend an IUD to a patient who has never been pregnant. Additionally, 61% believed that counseling patients about IUDs would take more time than other methods. Conclusions Misinformation about risks associated with IUDs and beliefs about patient eligibility may present barriers to provision. Apparent contradictions between knowledge and likelihood to recommend IUDs warrant further study.