{Reference Type}: Journal Article
{Title}: An Exploration of Contraceptive Choice Pathways in Adolescents and Young Adults.
{Author}: Ash MD;Watson IS;Matera LE;Ebersole AM;Stewart HL;Price E;Taylor J;Berlan ED;Bonny AE;
{Journal}: J Pediatr Adolesc Gynecol
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 11
{Factor}: 2.046
{DOI}: 10.1016/j.jpag.2024.06.009
{Abstract}: <B>OBJECTIVE: </B>To visualize contraceptive choice pathways among adolescent and young adults (AYA) designated female at birth (DFAB) as a means of exploring the relationships between current contraceptive use, desired contraceptive, and ultimately, chosen contraceptive method.<BR><B>METHODS: </B>A retrospective cross-sectional study was conducted of AYA DFAB (N=2369), aged 14-24 years, presenting for initial visit at a contraceptive clinic with standardized efficacy-based counseling. Sankey diagrams were utilized to visualize patient flow through the contraceptive decision-making process. Outcomes of interest were current contraceptive method, desired contraceptive prior to contraceptive counseling, and then chosen contraception. Chi-Square tests were conducted to quantify the strength of the relationships identified by the Sankey diagrams.<BR><B>RESULTS: </B>Sankey diagrams demonstrated a fair amount of change from current contraceptive to desired contraceptive and from current contraceptive to chosen contraceptive. A stronger relationship was evident between desired contraceptive method and chosen method; most patients did not change their desired contraceptive after receiving counseling except AYA who were undecided about their desired contraceptive who flowed variably into all available methods. Chi-Square test assessing the association between desired and chosen contraceptive method was significant at p-value <0.001, validating the patterns identified with the Sankey diagrams.<BR><B>CONCLUSIONS: </B>We identified distinct contraceptive decision-making pathways among AYA which could inform the framework for a more tailored counseling approach. These findings are aligned with national medical organizations' recommendations for provision of non-coercive, patient-centered contraceptive counseling to promote adolescent reproductive autonomy.