■在美国和全球,避孕药具获取的主要指标侧重于某些避孕方法的使用,没有解决自我定义的避孕需求;因此,这些指标未能关注以人为本,医疗质量的关键组成部分。这项研究通过提供美国关于首选避孕方法使用的新数据来解决这一差距,以人为中心的避孕药具获取指标。此外,我们研究了以人为中心的医疗服务的关键方面与首选避孕方法之间的关联.
■我们于2022年在美国进行了一项具有全国代表性的英语和西班牙语调查,调查了出生时无生育能力的15-44岁女性。在当前和未来的避孕药具使用者中(未加权n=2119),我们描述了首选的方法使用,不使用的原因,以及社会人口统计学特征在首选方法使用方面的差异。我们进行了逻辑回归分析,检查了以人为中心的医疗保健获取与首选避孕方法使用的四个方面之间的关联。
■四分之一(25.2%)的当前和预期用户报告说,他们希望使用另一种方法,选择口服避孕药和输精管结扎术。不使用首选避孕药的原因包括副作用(28.8%),与性有关的原因(25.1%),物流/知识壁垒(18.6%),安全问题(18.3%),和成本(17.6%)。在调整逻辑回归分析中,认为自己有足够信息选择适当避孕方法的受访者(调整后赔率比[AOR]3.31;95%CI2.10,5.21),他们非常(AOR9.24;95%CI4.29,19.91)或有些自信(AOR3.78;95%CI1.76,8.12)可以获得所需的避孕,曾接受以人为中心的避孕咨询(AOR1.72;95%CI1.33,2.23),并且在计划生育环境中没有经历过歧视(AOR1.58;95%CI1.13,2.20),使用首选避孕方法的几率增加.
■在美国,估计有810万人没有使用首选的避孕方法。干预应着眼于整体,以人为中心的避孕方法,考虑到信息的含义,自我效能感,以及对首选方法使用的歧视性照顾。
■阿诺德风投。
UNASSIGNED: In the U.S. and globally, dominant metrics of contraceptive access focus on the use of certain contraceptive methods and do not address self-defined need for contraception; therefore, these metrics fail to attend to person-centeredness, a key component of healthcare quality. This
study addresses this gap by presenting new data from the U.S. on preferred contraceptive method use, a person-centered contraceptive access indicator. Additionally, we examine the association between key aspects of person-centered healthcare access and preferred contraceptive method use.
UNASSIGNED: We fielded a nationally representative survey in the U.S. in English and Spanish in 2022, surveying non-sterile 15-44-year-olds assigned female sex at birth. Among current and prospective contraceptive users (unweighted n = 2119), we describe preferred method use, reasons for non-use, and differences in preferred method use by sociodemographic characteristics. We conduct logistic regression analyses examining the association between four aspects of person-centered healthcare access and preferred contraceptive method use.
UNASSIGNED: A quarter (25.2%) of current and prospective users reported there was another method they would like to use, with oral contraception and vasectomy most selected. Reasons for non-use of preferred contraception included side effects (28.8%), sex-related reasons (25.1%), logistics/knowledge barriers (18.6%), safety concerns (18.3%), and cost (17.6%). In adjusted logistic regression analyses, respondents who felt they had enough information to choose appropriate contraception (Adjusted Odds Ratio [AOR] 3.31; 95% CI 2.10, 5.21), were very (AOR 9.24; 95% CI 4.29, 19.91) or somewhat confident (AOR 3.78; 95% CI 1.76, 8.12) they could obtain desired contraception, had received person-centered contraceptive counseling (AOR 1.72; 95% CI 1.33, 2.23), and had not experienced discrimination in family planning settings (AOR 1.58; 95% CI 1.13, 2.20) had increased odds of preferred contraceptive method use.
UNASSIGNED: An estimated 8.1 million individuals in the U.S. are not using a preferred contraceptive method. Interventions should focus on holistic, person-centered contraceptive access, given the implications of information, self-efficacy, and discriminatory care for preferred method use.
UNASSIGNED: Arnold Ventures.