Determinants of Long-Acting Reversible Contraception (LARC) Initial and Continued Use Among Adolescents in the United States

C. Emily Hendrick, Joshua N. Cone, Jessica Cirullo, Julie Maslowsky

Research output: Contribution to journalReview article

Abstract

Long-acting reversible contraception (LARC) has gained attention as a promising strategy for preventing unintended adolescent pregnancies in the US. However, LARC use among adolescents at risk for unintended pregnancy remains low compared to women in their 20s. The purpose of the current study was to synthesize the empirical literature published between 2010 and 2018 identifying the facilitators of and barriers to adolescents’ (< age 20) LARC use in the US. Thirty quantitative and qualitative studies were included in the current systematic review. The facilitators of and barriers to adolescent LARC use fell within five themes: LARC method characteristics, individual characteristics, social networks, healthcare systems, and historical time and geographical region. Barriers to adolescent LARC use largely echoed those identified in previous research noting the barriers to LARC use among young adult women (e.g., navigation of healthcare system logistics, common adverse side effects associated with some LARC methods). However, qualitative studies identified adolescents’ mothers as central figures in helping adolescents successfully obtain the LARC methods they desired. Conversely, adolescents’ partners seemed to only play a minor role in adolescents’ contraceptive decisions. The findings also suggested some subpopulations of adolescents may be experiencing pressure to initiate LARC use or have less ability to have their LARC device removed if they wish to discontinue use. Adolescent health practitioners and clinicians should consider the unique social–environmental influences of adolescents’ contraceptive access and behaviors to best meet adolescents’ contraceptive needs and desires.

Original languageEnglish (US)
JournalAdolescent Research Review
DOIs
StatePublished - Jan 1 2019

Fingerprint

contraception
Contraception
determinants
adolescent
contraceptive
Contraceptive Agents
Contraception Behavior
Delivery of Health Care
Pregnancy in Adolescence
Adolescent Behavior
Aptitude
Social Support
Young Adult
young adult
Mothers
pregnancy
social network
Pressure
logistics
Equipment and Supplies

Keywords

  • Adolescent pregnancy
  • Adolescents
  • Barriers
  • Facilitators
  • LARC
  • Long-acting reversible contraception
  • Systematic review
  • Women

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Social Sciences (miscellaneous)
  • Psychiatry and Mental health

Cite this

Determinants of Long-Acting Reversible Contraception (LARC) Initial and Continued Use Among Adolescents in the United States. / Hendrick, C. Emily; Cone, Joshua N.; Cirullo, Jessica; Maslowsky, Julie.

In: Adolescent Research Review, 01.01.2019.

Research output: Contribution to journalReview article

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abstract = "Long-acting reversible contraception (LARC) has gained attention as a promising strategy for preventing unintended adolescent pregnancies in the US. However, LARC use among adolescents at risk for unintended pregnancy remains low compared to women in their 20s. The purpose of the current study was to synthesize the empirical literature published between 2010 and 2018 identifying the facilitators of and barriers to adolescents’ (< age 20) LARC use in the US. Thirty quantitative and qualitative studies were included in the current systematic review. The facilitators of and barriers to adolescent LARC use fell within five themes: LARC method characteristics, individual characteristics, social networks, healthcare systems, and historical time and geographical region. Barriers to adolescent LARC use largely echoed those identified in previous research noting the barriers to LARC use among young adult women (e.g., navigation of healthcare system logistics, common adverse side effects associated with some LARC methods). However, qualitative studies identified adolescents’ mothers as central figures in helping adolescents successfully obtain the LARC methods they desired. Conversely, adolescents’ partners seemed to only play a minor role in adolescents’ contraceptive decisions. The findings also suggested some subpopulations of adolescents may be experiencing pressure to initiate LARC use or have less ability to have their LARC device removed if they wish to discontinue use. Adolescent health practitioners and clinicians should consider the unique social–environmental influences of adolescents’ contraceptive access and behaviors to best meet adolescents’ contraceptive needs and desires.",
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