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Counseling about IUDs: a mixed-methods analysis
Christine Dehlendorf1, Mithu Tharayil, Nora Anderson
1Departments of Family and Community Medicine; Obstetrics, Gynecology and Reproductive Sciences; and Epidemiology and Biostatistics- University of California, San Francisco (UCSF). cdehlendorf@fcm.ucsf.edu.
Perspectives on Sexual and Reproductive Health
|March 18, 2014
Summary
Improving counseling on intrauterine devices (IUDs) can increase their use. Current IUD counseling is often not patient-centered and lacks comprehensiveness, creating barriers to access.
Area of Science:
- Reproductive Health
- Family Planning Services
- Medical Counseling
Background:
- Intrauterine devices (IUDs) are underutilized in the United States.
- Assessing counseling practices can reveal barriers to IUD adoption.
- Improving IUD services may increase method use.
Purpose of the Study:
- To evaluate the quality of counseling regarding intrauterine devices (IUDs) in family planning visits.
- To identify areas for improvement in IUD counseling to overcome barriers to use.
Main Methods:
- Audio-recorded 342 family planning visits and collected pre/post-visit surveys.
- Conducted descriptive quantitative and qualitative analyses of IUD counseling.
- Used logistic regression to investigate factors associated with IUD mention during visits.
Main Results:
- IUDs were mentioned in 75% of visits; patient-initiated discussion was higher in older women.
- Providers more frequently discussed IUD risks than benefits, with non-interactive counseling.
- Counseling was often fragmented, requiring return visits or referrals for IUD insertion.
Conclusions:
- Enhancing the comprehensiveness and patient-centeredness of IUD counseling is crucial.
- Reducing fragmentation in care delivery can improve the IUD experience.
- Optimizing IUD counseling may help reduce barriers and increase utilization.
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