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At least 217 records · Page 12Linked to original sources
PubMed1995

Unintended pregnancies and use, misuse and discontinuation of oral contraceptives.

Unintended pregnancies are a recognized occurrence among women using oral contraceptives (OCs) as a consequence of both user and method failure. However, OCs also influence the occurrence of unintended pregnancies through an additional, poorly recognized, route: cessation of OC use by women who do not wish to become pregnant but stop using OCs because of side effects or other reasons. Many such women fail to immediately substitute a new contraceptive and/or adopt a less reliable contraceptive. This is a particularly important consideration for the approximately 3.7 million women who begin taking OCs in the United States each year since this group commonly experiences side effects and has a high discontinuation rate. Using a decision tree to follow a cohort of OC users over one year, we estimate that over 1 million unintended pregnancies are related to OC use, misuse or discontinuation. The greatest proportion of these, 61%, occur in women who discontinue OCs; of these, 66.6% occur in women who fail to immediately substitute other contraceptives and 33.3% because of the adoption of less reliable contraceptive methods. Of continuing OC users, the majority, exhibiting good compliance, contribute 24% of pregnancies because of their large numbers. Continuing OC users who are poor compliers, though many fewer, are responsible for 15% due to their high pregnancy rate. Unintended pregnancies in women who discontinue OCs account for approximately 20% of the 3.5 million annual unintended pregnancies in the United States, incurring costs of nearly +2.6 billion.(ABSTRACT TRUNCATED AT 250 WORDS)

Contraception Behavior↗
PubMedDate not supplied

Impact of the integrated Radio Communication Project in Nepal, 1994-1997.

The Radio Communication Project (RCP) in Nepal is an ongoing, theory-based, multimedia reproductive health campaign which began in 1995. It consists of two entertainment-education radio serials (a soap opera for the general public and a dramatized distance education serial for health workers), additional radio spot advertisements and promotions, and complementary print materials. This paper examines impact data from a variety of sources, including a pre- and postpanel survey of currently married women (N = 1905), three waves of clinic-based observations of client-provider interactions (N = 240 per wave) and client exit interviews (N = 240 per wave), and 2 years of clinic service statistics, in order to draw inferences about the separate and combined effects of the RCP components. The study found increased health worker interpersonal interaction skills, improved quality of client-provider interactions, increased client self-efficacy in dealing with health workers, improved client attitudes toward health services and toward the practice of family planning, increased adoption of family planning, and increased family planning service utilization, all attributable to the RCP. The panel data allowed statistical control of the influence of predisposing factors before the campaign on postcampaign ideation and behavior. The effect of the RCP on contraceptive behavior was largely indirect through its influence on ideation. Implications for the design of integrated, multimedia, entertainment-education campaigns and integrated evaluation designs are discussed.

Female↗
PubMedDate not supplied

The effects of contraceptive education on method use at first intercourse.

Despite long-standing public support for sex education in the schools, it has been difficult to show concrete effects of sex education on sexual and contraceptive behavior. Data from the 1988 National Survey of Family Growth indicate that exposure to a formal contraceptive education program increases the likelihood that a teenage woman will use a contraceptive method at first intercourse. According to the results of a multivariate analysis, the odds that a young woman will use any method and the odds that she will use a condom increase by about one-third following instruction about birth control; the effect on the likelihood of pill use, however, is nonsignificant. If contraceptive education occurs in the same year that a teenager becomes sexually active, the odds of any method use and of condom use are increased by 70-80%, and the odds of pill use are more than doubled. The results also suggest that with greater educational efforts, the proportion of teenagers who use condoms at first intercourse could increase from 52% to 59%, while the proportion using no method might decrease from 41% to 33%.

Adolescent↗
PubMed1996

Through the patient's eyes: strategies toward more successful contraception.

OBJECTIVE: To review the literature focusing on studies of patient satisfaction and patient involvement in the design of care and to suggest strategies for involving patients effectively in their care. While addressing issues in contraception and adherence to contraceptive regimens, we write from the perspective of general physicians who manage patients with a broad variety of problems. By learning systematically what patients want, need, and experience in health and illness, we can use such information in the redesign and improvement of care. DATA SOURCES: Individual anecdote, focus groups of patients, patient survey data, and a literature review were used. METHODS OF STUDY SELECTION: The literature review used an English-language search of MEDLINE from 1970 to 1996, with search terms including patient satisfaction, consumer participation, patient participation, self-care, contraception, and contraceptive behavior. Previous studies conducted by the authors were also reviewed. TABULATION, INTEGRATION, AND RESULTS: Patients report that providers who solicit patients needs and preferences for involvement in decision making, who encourage family involvement, and who tailor educational efforts to the individual adult learning style of the patient engender greater patient satisfaction, adherence to recommended therapies, and improved patient outcomes. Recent trends in the United States, such as the growing use of alternative therapies, the self-help movement, and consumerism have influenced patient attitudes and behaviors toward seeking care and are changing their behavior. We discuss several strategies to improve patient involvement in their care, including the use of patient diaries and contracts, pre- and post-visit preparation and communication, the involvement of patients in educating providers, and the use of information technologies to enhance communication between patients and providers. CONCLUSIONS: Patient involvement in the redesign of care may help promote greater effectiveness of contraceptive strategies.

Adult↗
PubMed2003

Contraception and abortion attitudes and practices of Western Ukraine women.

OBJECTIVES: To assess the attitudes and practices of contraceptive behaviors of Western Ukraine women. METHODS: A survey of 500 women in the Oblast was conducted to assess their knowledge, attitudes and practices on a variety of health topics. Convenience sampling was used to access the subjects in 16 different towns/villages in nine rayons throughout the Oblast. Respondents were asked more than 100 questions pertaining to their knowledge, attitudes and practices on a variety of health topics, including stress, contraception, breast health, sexually transmitted diseases, parity, abortion, nutrition, alcohol and tobacco use, domestic violence, and depression and mental health. RESULTS: Of married women, 44% (112/256) would terminate their pregnancy while 56% (144/256) said they would keep their baby. Of unmarried women, 35% (31/88) would abort while 65% (57/88) would keep their baby. A large proportion of married women (82%; 222/271) and unmarried women (70%; 52/74) did not use condoms at all. CONCLUSION: These results suggest lack of birth control education and contribution to poor protection from sexually transmitted infections. Higher abortion practices may also play a role in the infertility issues that Ukrainian women currently face.

Abortion, Induced↗
PubMed1988

Abortions among Israeli women after interruption in contraceptive use.

Seventy-two Israeli women who underwent abortions were interviewed. Most of those interviewed had used modern contraceptives previously, but not before their most recent pregnancy. The interruption in contraceptive use resulted from adverse side effects of the contraceptives and instability in partner relationships.

Abortion, Induced↗
PubMed1989

Adolescents and condoms. Associations of beliefs with intentions to use.

Sexually active adolescents should use condoms to prevent the transmission of sexually transmitted diseases, including human immunodeficiency virus. This study examined, among male and female adolescents, which beliefs about condoms are associated with intentions to use them if they have coitus in the next year. Teenagers attending adolescent health clinics completed self-administered surveys. Although most adolescents knew that condoms prevent sexually transmitted diseases, an increasing belief in the preventive effects of condoms was not associated with an increased motivation to use them. Instead, other immediate, short-term consequences, such as the ease with which they can be used and discomfort associated with their use, were most strongly associated with adolescents' intentions to use condoms. To encourage condom use, messages from physicians and other health care professionals must focus on adolescents' beliefs that are most likely to encourage or inhibit use of condoms. Health considerations should not be the sole emphasis of such communications if the goal is to increase the use of condoms among sexually active adolescents.

Adolescent↗
PubMed1991

Reexamination of Eisen, Zellman, and McAlister's Health Belief Model questionnaire.

Eisen, Zellman, and McAlister proposed a 22-item scale to measure four Health Belief Model (HBM) constructs as applied to adolescent contraceptive behavior. Their factor analysis led them to conclude that there were several discrepancies in their proposed scales. We suggest that they were unduly pessimistic. Although their proposed scales could stand improvement, they are adequate preliminary tools. The major reason they concluded that the scales were deficient was that they applied criteria that are generally appropriate for continuous data to their inherently discrete (categorical) item response data. A secondary consideration is that confirmatory methods of factor analysis can yield results that bear more directly on their proposed organization of items than the traditional exploratory methods that they used. A reanalysis of their data suggests that their proposed scales have fewer problems than they believed they had. Our results increase the likelihood of standardizing HBM measures.

Adolescent↗
PubMedDate not supplied

Teenagers' perceptions of unplanned adolescent pregnancies and oral contraceptive use.

Adolescent women who are sexually active often do not use contraceptives consistently and correctly. Adolescents are sexually active for an average of 15 months before initiating regular contraceptive use and the majority of young women who initiate use discontinue within the first year after initiation. This study enrolled 50 young women who initiated oral contraceptive use and was designed to provide more understanding of their perceptions about the possibility of an unplanned pregnancy and about contraceptive use. They were again contacted 6 weeks after initiation of oral contraceptives to assess continuation. Findings revealed that 90% of the subjects were sexually active at the time of the first visit; the mean period of sexual activity was 15 months. Only 30% had used a nonprescription birth control method during this period. While perceiving themselves to be highly susceptible to pregnancy, many young women continue to have psychosocial barriers to contraceptive use. Follow-up contact revealed more than 10% of the subjects were not using oral contraceptives.

Adolescent↗
PubMed1985

Birth control use by teenagers. One and two years postabortion.

A prospective study was undertaken of the contraceptive behavior of adolescent women following a first-trimester abortion. Each women had an individual counseling session, including birth-control counseling. Effective birth control was used by 77% of the 182 respondents one year postabortion. Two years after abortion, 79% of those who remained in the study group continued to use reliable birth control methods. The repeat abortion rate for all respondents was 7% in the first year and 11% in the second year. These results suggest that teenagers who obtain abortions do not rely on the procedure as a method of contraception. Instead, they are more likely to be using reliable methods of birth control postabortion than they were before the unplanned pregnancy.

Abortion, Induced↗
PubMed1981

Response of unmarried adolescents to contraceptive advice and service in Nigeria.

The responses of a group of all unmarried, sexually active teenagers in a developing country to offers of contraceptive service were assessed in a prospective, 30-month study at a teaching hospital family planning center. Teenagers of this group constituted 7.2% of the clinic population. The default rate was very high (43.0%) and was most noticeable among users of oral contraceptives. The intrauterine device seemed more acceptable, as were injections of norethisterone enanthate. Possible reasons for this pattern of response are given, and the authors suggest giving new consideration to making the intrauterine device more suitable for and acceptable to teenagers of developing countries. The place of norethisterone enanthate in teenage contraception is also discussed.

Adolescent↗