Factors associated with provision of depot medroxyprogesterone acetate to adolescents by US health care providers☆☆,★

Details

• Alternative Title:
  Contraception
• Personal Author:
  Ermias, Y. ; Morgan, I.A. ; Curtis, K.M. ; Whiteman, M.K. ; Horton, L.G. ; Zapata, L.B.
• Description:
  Objective:
  
  Identify factors associated with healthcare providers’ frequency of depot medroxyprogesterone acetate (DMPA) provision to adolescents.
  
  Study design:
  
  We analyzed data from surveys mailed to a nationally representative sample of public-sector providers and office-based physicians (n=1984). We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of factors associated with frequent DMPA provision to adolescents in the past year.
  
  Results:
  
  Although most providers (>95%) considered DMPA safe for adolescents, fewer reported frequent provision (89% of public-sector providers; 64% of office-based physicians). Among public-sector providers, factors associated with lower odds of frequent provision included working in settings without Title X funding (aOR 0.44, 95% CI 0.30–0.64), reporting primary care as their primary clinical focus versus reproductive or adolescent health (aOR 0.42, 95% CI 0.28–0.61), and providing fewer patients with family planning services. Among office-based physicians, factors associated with lower odds of frequent provision included specializing in obstetrics/gynecology (aOR 0.50, 95% CI 0.27–0.91) and family medicine (aOR 0.21, 95% CI 0.09–0.47) versus adolescent medicine, completing training ≥15 versus <5 years ago (aOR 0.27, 95% CI 0.09–0.83), and reporting that 0–24% of patients pay with Medicaid or other government healthcare assistance versus ≥50% (aOR 0.23, 95% CI 0.09–0.61). The reason most commonly reported by providers for infrequent DMPA provision was patient preference for another method.
  
  Conclusions:
  
  While most providers reported frequently providing DMPA to adolescents, training on evidence-based recommendations for contraception, focused on subgroups of providers with lower odds of frequent DMPA provision, may increase adolescents’ access to contraception.
  
  Implications:
  
  Although >95% of providers considered depot medroxyprogesterone (DMPA) a safe contraceptive for adolescents, only 89% of public-sector providers and 64% of office-based physicians reported frequently providing DMPA to adolescents. Provider training on evidence-based recommendations for contraception counseling and provision may increase adolescents’ access to DMPA and all methods of contraception.
  
  
• Subjects:
  Adolescent Adolescent Health Contraceptive Agents, Hormonal Female Health Knowledge, Attitudes, Practice Health Personnel Humans Logistic Models Medroxyprogesterone Acetate Pregnancy Pregnancy In Adolescence Surveys And Questionnaires United States

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• Keywords:
  Adolescent Health Contraception Depot Medroxyprogesterone Acetate Healthcare Provider Survey
• Source:
  Contraception. 99(5):300-305
• Pubmed ID:
  30763582
• Pubmed Central ID:
  PMC10966425
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U36 OE000002/OE/OSELS CDC HHSUnited States/
• Volume:
  99
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:459d9142b21d3f7aebf504d0f366b7087ad95ce2793d50c800d83002f9ee2c72
• Download URL:
  https://stacks.cdc.gov/view/cdc/153574/cdc_153574_DS1.pdf
• File Type:
  [PDF - 343.93 KB ]