TOP 26 - Adolescent Preferences for Contraceptive Counseling in Primary Care

Publication Number: 2777.TOP 26

Olivia S. Legan, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Jane Nathanson, CHOP, Perelman School of Medicine, Philadelphia, PA, United States; Polina Krass, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Cynthia Mollen, Childrens Hospital of Philadelphia, Philadelphia, PA, United States

Background: Contraceptive counseling is a key primary prevention strategy for unintended teen pregnancy and sexually transmitted infections. Major medical societies, including the American Academy of Pediatrics (AAP), recommend that person-centered contraceptive counseling be incorporated into routine adolescent primary care. However, it is well-established that pediatricians do not discuss safe sex and contraception as frequently or as comprehensively as recommended by the AAP. There is limited data on how to best implement person-centered contraceptive counseling in pediatric primary care practice, and the data that does exist focuses on the provider perspective, rather than the perspective of the adolescent patient. Understanding the experiences and preferences of adolescents in receiving sexual and reproductive healthcare in the primary care setting is a critical step towards improving adherence to best-practice adolescent primary care.

Objective: This study primarily aimed to understand adolescent preferences for person-centered contraceptive counseling in the primary care setting. It secondarily aimed to explore adolescent perspectives on specific contraceptive counseling decision aids that could be implemented in the pediatric primary care setting.

Design/Methods: This is a cross-sectional, qualitative study of patients aged 13 -18 years old presenting for a well visit at an outpatient primary care clinic. Semi-structured, in-person interviews lasting ~30 minutes were conducted following a routine well child visit using a purposive sampling approach to ensure diversity of genders and sexual experiences. Preliminary assessment of thematic saturation was reached after 20 interviews. Prior to the interview, patients filled out a demographic survey. In the first phase of the interview, the patient's preferences and experiences were elicited, using the following framework: 1. Reflection on the adolescent well visit, and the patient's satisfaction with and improvements in contraception counseling, 2. Current sources of knowledge on contraception, 3. Reflection on clinic resources, 4. Social norms/peer perceptions of contraception. In the second phase of the interview, participants were presented with four distinct contraceptive counseling tools (two posters with QR codes, one 3D counseling tool, and one paper packet) in alternating order and asked for their feedback and preferences. Interviews were recorded and transcribed to ANT by Datagain, and analysis is in progress using a grounded theory approach to identify themes. The expected timeline for completion of data analysis is one month.

Table 1. Participant demographics (N = 20)
Self-reported patient demographic information and sexual experiences

Image 1. Four contraceptive counseling tools presented to participants
In the second phase of the interview, participants were presented with four distinct contraceptive counseling tools/interventions and asked for feedback and preferences.