Effect of Prior Adverse Reproductive Health Outcomes on Young Women's Engagement in a Health Coaching Intervention to Improve Contraceptive Continuation.

TitleEffect of Prior Adverse Reproductive Health Outcomes on Young Women's Engagement in a Health Coaching Intervention to Improve Contraceptive Continuation.
Publication TypeJournal Article
Year of Publication2021
AuthorsAmutah C, Petsis D, Fields NF, Wood S, Timko A, Akers AY
JournalJ Pediatr Adolesc Gynecol
Date Published2021 Feb 08
ISSN1873-4332
Abstract

OBJECTIVE: Nonadherence in sexual risk reduction interventions may be common among adolescents. We compared intervention completion rates among adolescent and young adult women with and without a prior pregnancy or sexually transmitted infection (STI) participating in a program to improve contraceptive continuation.

DESIGN: Secondary data analysis from a feasibility study of a health coaching intervention to improve contraceptive continuation.

SETTING: Three urban pediatric clinics in Philadelphia.

PARTICIPANTS: Women ages 14-22 years who were English-speaking, sexually active in the past year, not desiring pregnancy in the next year, and starting a new contraceptive method.

INTERVENTIONS: At baseline, participants completed a sociodemographic questionnaire and semi-structured interview, followed by five monthly coaching sessions. Interviews and coaching sessions were audio-recorded, transcribed, and coded for thematic content.

MAIN OUTCOME MEASURES: Intervention completion was defined as the number of completed coaching sessions.

SECONDARY OUTCOMES: Qualitatively explored group differences in reproductive knowledge, attitudes, and risk perception.

RESULTS: Participants with a prior adverse outcome (a prior STI and/or a prior pregnancy) completed fewer coaching sessions than those without such history (median: 2 vs. 4, p=0.03). Both groups had low HIV/STI knowledge, negative attitudes towards pregnancy, and low HIV/STI risk perception. Those with a prior adverse reproductive outcome held more negative attitudes towards condoms.

CONCLUSION: Despite similar reproductive knowledge, attitudes, and risk perception, young women who have experienced an adverse reproductive outcome may be less likely to fully engage in sexual risk reduction interventions. Future studies should confirm these findings and consider strategies to optimize interventions reach for vulnerable youth.

DOI10.1016/j.jpag.2021.02.003
Alternate JournalJ Pediatr Adolesc Gynecol
PubMed ID33571659