497 - Characteristics of caregivers who prefer LARCs for their adolescent daughters

Poster Number: 497
Publication Number: 497.100

Angela Wang, University of Texas Southwestern Medical School, Flower Mound, TX, United States; Courtney McNeely, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Victoria K. Sanchez, Oregon Health and Science University, Portland, OR, United States; Julia C. Durante, University of Texas Southwestern Medical School, Dallas, TX, United States; Jasmin A. Tiro, UT Southwestern Medical Center, Dallas, TX, United States; Katelyn K. Jetelina, UTHealth, Dallas, TX, United States; Jenny Francis, University of Texas Southwestern Medical School, Dallas, TX, United States

Background: Long-acting reversible contraception (LARC), including the intrauterine device (IUD) and the contraceptive implant (henceforth implant), is a first line option for adolescent pregnancy prevention. Parental consent for adolescent LARC initiation is required by some state laws. Understanding characteristics of caregivers who prefer LARC could assist providers in adolescent contraception counseling.

Objective: To characterize caregivers who prefer LARC compared to non-LARC methods for their adolescent daughters.

Design/Methods: Caregivers with an index daughter 9 years or older were recruited in the community to complete a bilingual cross-sectional survey that measured demographics, caregiver reproductive and contraceptive history, and preferences for adolescent contraception. The two main outcome variables were caregivers’ perceived best birth control method for their daughters (13 contraceptive options collapsed into LARC vs non-LARC for bivariate analysis) and caregivers’ willingness to allow daughters to use an implant/IUD (each measured on a 5-point Likert scale from “not at all willing” to “very willing” combined into a 10-point scale for multivariate regression analysis).

Results: Of the 115 caregivers, 93% were female, 78% Hispanic, 73% foreign-born, and 42% reported being a teenager (≤19 years) when they began caring for their first child. Overall, 42% of caregivers had personal LARC experience, 44% perceived LARC as the best contraceptive method for their daughters, and 35% were very/somewhat willing to allow daughters to use LARC. Bivariate analysis showed past caregiver implant use (p = 0.013), caregivers’ likelihood of using LARC themselves (p =0.009), and belief that LARC can best prevent pregnancy (p = 0.001) were associated with caregivers reporting LARC as the best birth control method for their daughters. After controlling for caregiver demographics, the only item positively associated with caregivers’ willingness to allow daughters to use LARCs was caregivers’ own likelihood of using LARC (p = 0.018).Conclusion(s): Caregivers personal contraceptive experiences and personal desire to use LARC influences their willingness to allow their daughters to use LARC. Providers should tailor adolescent contraception counseling to include caregivers’ contraceptive experiences, attitudes, and preferences. Future studies should design and evaluate tailored messages to highlight the importance provider communication skills with caregivers.

Funding: NIH K23 HD097291, Pilot Community-based University Award: Program for the Development and Evaluation of Model Community Health Initiatives in Dallas
APA Award Submission CV ACWWang UTSW CV.pdf