TOPLINE:

Person-centered contraceptive counseling (PCCC) was received by only one third of adolescents aged 15-19 years compared with nearly half of adults aged ≥ 25 years, yet adolescents who received PCCC were more than twice as likely to use their preferred contraceptive method.

METHODOLOGY:

• Researchers analyzed data from 2043 self-identified female respondents who had a contraceptive care visit in the past year, including 261 adolescents aged 15-19 years, 276 young adults aged 20-24 years, and 1506 adults aged ≥ 25 years.
• Analysis utilized the 2022-2023 National Survey of Family Growth (NSFG), a nationally representative survey that oversampled Black and Hispanic participants and adolescents aged 15-19 years in the US.
• Participants rated their most recent family planning clinician experience on a 5-point scale across items on the PCCC scale, measuring respect, preference consideration, and information provision.
• Outcome measures included receipt of PCCC and preferred contraceptive method use, with multivariable logistic regression analyses and 95% CIs used to assess data.

TAKEAWAY:

• Adolescents aged 15-19 years had significantly lower odds of receiving PCCC than adults aged ≥ 25 years (adjusted odds ratio [aOR], 0.61; 99% CI, 0.37-0.99).
• Among adolescents who received PCCC, the odds of using their preferred contraceptive method were significantly higher than those among adolescents who did not receive PCCC (aOR, 2.35; 95% CI, 1.06-5.21).
• Respondents with low English proficiency (aOR, 0.36; 99% CI, 0.19-0.69) and those receiving care at public clinics (aOR, 0.56; 99% CI, 0.37-0.85) showed significantly lower odds of rating their clinician as excellent on all PCCC items.
• No significant differences were found in preferred contraceptive method use by PCCC among young adults (aOR, 0.57; 95% CI, 0.25-1.26) or adults (aOR, 1.01; 95% CI, 0.70-1.45).

IN PRACTICE:

“These findings support ongoing efforts to improve the quality of contraceptive counseling for adolescents through person-centered approaches that provide comprehensive information, respect their preferences, and support their autonomy,” wrote the authors of the study.

SOURCE:

The study was led by Brooke Whitfield, PhD, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. It was published online on December 26 in JAMA Network Open.

LIMITATIONS:

The measure of preferred contraceptive method use in the NSFG was limited because it only focused on cost-related factors, overlooking other important dimensions of method satisfaction such as adverse effects, access, confidentiality, and personal preferences. Additionally, the study could not examine variation by clinician type, which could be an important mediating factor in the quality of PCCC that adolescents receive. The researchers also noted that the PCCC measure has not been validated with robust adolescent populations and does not address clinician coercion or other forms of pressure and influence on contraceptive choices — an issue to which adolescents are particularly vulnerable.

DISCLOSURES:

Tracey Wilkinson, MD, MPH, disclosed receiving grants from CooperSurgical, Organon, and Bayer outside the submitted work. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.