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Patel PR, Nandigam L, Thompson J, Abacan A, Raphael M. The Impact of Get It? on Long-Acting Reversible Contraception Use Among Adolescents and Young Adults. J Pediatr Adolesc Gynecol 2024; 37:156-159. [PMID: 37977435 DOI: 10.1016/j.jpag.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Long-acting reversible contraceptives (LARCs) are the most effective contraceptive method to decrease pregnancy rates among adolescents and young adults (AYAs). Get It? (www.getitnobaby.com) is an innovative peer-based digital intervention that aims to increase LARC awareness and use among AYAs. The purpose of this study was to describe the impact of Get It? on LARC awareness and use among AYAs after exposure. METHODS A randomized controlled trial was conducted between 2 different Baylor College of Medicine Teen Health Clinics. Using a block randomization method, clinics were randomized to either the intervention or control group by week. Baseline and post-intervention surveys were conducted in addition to a 6-month post-intervention chart review to determine the primary outcome of LARC uptake and secondary outcomes including other LARC-specific behaviors and LARC attitudes. RESULTS A total of 233 AYAs agreed to participate in the study, of which 134 were randomized to the control group and 99 to the intervention group. Initiation of LARC discussion with the provider was significantly higher in the intervention group than in the control group. Additionally, LARC uptake within 6 months after study was almost significantly higher in the intervention group than in the control group. Finally, intervention group respondents exhibited strong positive attitudes toward Get It? with regard to specific intervention components. CONCLUSION This study supports Get It? as a tool to educate and motivate AYA girls to use the most effective form of birth control available to them. The digital format of this novel peer-based approach also contributes to the potential of this educational intervention by decreasing barriers to both dissemination and uptake. We recommend a larger multi-institutional study to confirm these results and determine the most efficient method of dissemination to reach at-risk AYAs before coitarche.
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Affiliation(s)
- Pooja R Patel
- Department of Obstetrics and Gynecology, Baylor College of Medicine.
| | - Likhita Nandigam
- Department of Obstetrics and Gynecology, Baylor College of Medicine
| | - Jada Thompson
- Department of Obstetrics and Gynecology, Baylor College of Medicine
| | - Allyssa Abacan
- Department of Obstetrics and Gynecology, Baylor College of Medicine
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de Londras F, Cleeve A, Rodriguez MI, Farrell A, Furgalska M, Lavelanet AF. The impact of third-party authorization requirements on abortion-related outcomes: a synthesis of legal and health evidence. BMC Public Health 2023; 23:2065. [PMID: 37872513 PMCID: PMC10591342 DOI: 10.1186/s12889-023-16307-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/13/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVES This review synthesizes legal and health evidence to demonstrate the health and human rights impacts of third-party authorization requirements (TPAs) on abortion seekers. RESULTS The synthesized evidence substantiates the pre-existing position in international human rights law that requirements that abortion be authorized by third parties like parents, spouses, committees, and courts create barriers to abortion, should not be introduced at all, or should be repealed where they exist. CONCLUSIONS The review establishes that rights-based regulation of abortion should not impose TPAs in any circumstances. Instead, the provision and management of abortion should be treated in a manner cognizant with the general principles of informed consent in international human rights law, presuming capacity in all adults regardless of marital status and treatment sought, and recognizing the evolving capacity of young people in line with their internationally-protected rights.
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Affiliation(s)
- Fiona de Londras
- Birmingham Law School, University of Birmingham, B15 2TT, Birmingham, UK.
| | - Amanda Cleeve
- Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- South General Hospital (Södersjukhuset), Stockholm, Sweden
| | - Maria I Rodriguez
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Alana Farrell
- Birmingham Law School, University of Birmingham, B15 2TT, Birmingham, UK
| | | | - Antonella F Lavelanet
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Wells JM, Shi J, Bonny AE, Leonard JC. The Association of Emergency Contraception Legislation with Adolescent Births from 2000 to 2014. J Pediatr Adolesc Gynecol 2022; 35:462-466. [PMID: 35124213 DOI: 10.1016/j.jpag.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE The objective of the study was to examine the association of state-specific emergency contraception (EC) legislation and adolescent births. DESIGN, SETTING, AND PARTICIPANTS This was an observational cohort study of adolescents aged 15-19 years in the United States from 2000 through 2014 to determine the association of adolescent birth estimates with EC legislation. MAIN OUTCOME MEASURES State-specific birth and abortion estimate data were obtained from the Centers for Disease Control and Prevention's National Vital Statistics and Abortion Surveillance for the years 2000 through 2014. RESULTS After controlling for year, abortion estimates, and oral contraception pill utilization, estimated adolescent births for states with an expansive EC policy was 14% lower as compared with states without an expansive policy. Estimated adolescent births were 43% higher in states with a restrictive EC policy as compared with states without a restrictive policy. CONCLUSION Restrictive EC policies are associated with increased adolescent birth estimates, whereas expansive EC policies are associated with decreased adolescent birth estimates. Targeted advocacy strategies to reduce legislation that aims to restrict access to contraception may prove to be most beneficial to reducing unintended pregnancies.
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Affiliation(s)
- Jordee M Wells
- Department of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205; Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205; The Ohio State University College of Medicine, 370 W 9th Avenue, Columbus, Ohio 43210.
| | - Junxin Shi
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205
| | - Andrea E Bonny
- The Ohio State University College of Medicine, 370 W 9th Avenue, Columbus, Ohio 43210; Department of Pediatrics, Division of Adolescent Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205; Center for Clinical and Translational Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205
| | - Julie C Leonard
- Department of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205; The Ohio State University College of Medicine, 370 W 9th Avenue, Columbus, Ohio 43210; Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205
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Rodgers YVDM, Coast E, Lattof SR, Poss C, Moore B. The macroeconomics of abortion: A scoping review and analysis of the costs and outcomes. PLoS One 2021; 16:e0250692. [PMID: 33956826 PMCID: PMC8101771 DOI: 10.1371/journal.pone.0250692] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/25/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although abortion is a common gynecological procedure around the globe, we lack synthesis of the known macroeconomic costs and outcomes of abortion care and abortion policies. This scoping review synthesizes the literature on the impact of abortion-related care and abortion policies on economic outcomes at the macroeconomic level (that is, for societies and nation states). METHODS AND FINDINGS Searches were conducted in eight electronic databases. We conducted the searches and application of inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined one of the following macroeconomic outcomes: costs, impacts, benefits, and/or value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 189 data extractions with macroeconomic evidence, costs at the national level are the most frequently reported economic outcome (n = 97), followed by impacts (n = 66), and benefits/value (n = 26). Findings show that post-abortion care services can constitute a substantial portion of national expenditures on health. Public sector coverage of abortion costs is sparse, and individuals bear most of the costs. Evidence also indicates that liberalizing abortion laws can have positive spillover effects for women's educational attainment and labor supply, and that access to abortion services contributes to improvements in children's human capital. However, the political economy around abortion legislation remains complicated and controversial. CONCLUSIONS Given the highly charged political nature of abortion around the global and the preponderance of rhetoric that can cloud reality in policy dialogues, it is imperative that social science researchers build the evidence base on the macroeconomic outcomes of abortion services and regulations.
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Affiliation(s)
- Yana van der Meulen Rodgers
- Department of Labor Studies and Employment Relations, Rutgers University, Piscataway, New Jersey, United States of America
- Department of Women’s and Gender Studies, Rutgers University, Piscataway, New Jersey, United States of America
- * E-mail:
| | - Ernestina Coast
- Department of International Development, London School of Economics and Political Science, London, United Kingdom
| | - Samantha R. Lattof
- Department of International Development, London School of Economics and Political Science, London, United Kingdom
| | - Cheri Poss
- Ipas, Chapel Hill, North Carolina, United States of America
| | - Brittany Moore
- Ipas, Chapel Hill, North Carolina, United States of America
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Abstract
Teen pregnancy and sexually transmitted infections are leading public health problems in the United States. While abstaining from sexual intercourse is the best way to avoid these conditions, abstinence only education (AOE) programs in schools have been shown ineffective in delaying sexual initiation or decreasing the teen pregnancy rate. Conversely, comprehensive sex education (CSE) programs have demonstrated the ability to decrease teen pregnancy and delay initiation into sex. However, federal funding continues to primarily support AOE programs, and a majority of states favor AOE in schools, rather than CSE. The purpose of this review was to examine the role of policy on sexual health education, which can have an impact on the health and well-being of adolescents. The review provides school nurses with information to help them educate parents and administrators to the negative repercussions of AOE, so they can advocate for policy change.
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Affiliation(s)
- Maureen Rabbitte
- 1 Sinclair School of Nursing, University of Missouri, Columbia, MO, USA.,2 Saint Xavier University, Chicago, IL, USA
| | - Maithe Enriquez
- 1 Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
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Santelli JS, Kantor LM, Grilo SA, Speizer IS, Lindberg LD, Heitel J, Schalet AT, Lyon ME, Mason-Jones AJ, McGovern T, Heck CJ, Rogers J, Ott MA. Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact. J Adolesc Health 2017; 61:273-280. [PMID: 28842065 DOI: 10.1016/j.jadohealth.2017.05.031] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/29/2017] [Accepted: 05/18/2017] [Indexed: 10/19/2022]
Abstract
Adolescence is marked by the emergence of human sexuality, sexual identity, and the initiation of intimate relations; within this context, abstinence from sexual intercourse can be a healthy choice. However, programs that promote abstinence-only-until-marriage (AOUM) or sexual risk avoidance are scientifically and ethically problematic and-as such-have been widely rejected by medical and public health professionals. Although abstinence is theoretically effective, in actual practice, intentions to abstain from sexual activity often fail. Given a rising age at first marriage around the world, a rapidly declining percentage of young people remain abstinent until marriage. Promotion of AOUM policies by the U.S. government has undermined sexuality education in the United States and in U.S. foreign aid programs; funding for AOUM continues in the United States. The weight of scientific evidence finds that AOUM programs are not effective in delaying initiation of sexual intercourse or changing other sexual risk behaviors. AOUM programs, as defined by U.S. federal funding requirements, inherently withhold information about human sexuality and may provide medically inaccurate and stigmatizing information. Thus, AOUM programs threaten fundamental human rights to health, information, and life. Young people need access to accurate and comprehensive sexual health information to protect their health and lives.
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Affiliation(s)
- John S Santelli
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York.
| | - Leslie M Kantor
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York; Planned Parenthood Federation of America, New York, New York
| | - Stephanie A Grilo
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Ilene S Speizer
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Jennifer Heitel
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York
| | - Amy T Schalet
- Department of Sociology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Maureen E Lyon
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Children's National Medical Center, George Washington University Medical Center, Washington, DC
| | | | - Terry McGovern
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York
| | - Craig J Heck
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York
| | | | - Mary A Ott
- Department of Pediatrics, Indiana University, Indianapolis, Indiana
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