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Study Objective: The aim of this project was to investigate adolescent perspectives on family planning services at a community-health center, with the intent to inform health center programs aimed at stemming the adolescent pregnancy rate., Design: This project was cross-sectional and employed mixed methods, including surveys and interviews, for the purposes of quality improvement., Setting: The project was conducted in the obstetrics and gynecology clinic at an urban community health center in Boston., Participants: Twenty adolescent females (age 16-20) who used services at the health center., Intervention: Participants were individually interviewed to assess perspectives on family planning services and to identify major influences on methods of pregnancy prevention., Main Outcome Measure: Major themes were categorized into contraceptive usage, reproductive health knowledge, adult influence and communication, barriers to contraceptive care and expectations of a family planning clinic., Results: All participants were sexually active and 80% had experienced pregnancy. Reproductive health knowledge was variable and in many cases limited. Concern about disapproval was a prominent barrier to going to a clinician for contraception or advice and parents were not often involved in the initial contraception discussion. Other barriers to use of contraception included forgetting to use the methods and fear of side effects., Conclusion: We identified several potentially modifiable factors, including lack of knowledge, concern for provider disapproval and fear of side effects that may limit effective use of family planning services by adolescents. Further attention should be paid to these factors in designing and improving youth-friendly services in ob-gyn clinics., (Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Background: Unintended and adolescent pregnancy disproportionately affects minority populations, but the effect of age, race and ethnicity on the use of long-acting reversible contraception (LARC) has not been well studied., Objective: The objective of this pilot study was to examine LARC use over a 5-year period among women receiving care at a Boston community health center., Methods: Retrospective cohort study of LARC method use among black, Hispanic, and white women receiving care at the Dimock Center from 2006 to 2010., Results: This study included 276 women (60.1% black, 18.5% Hispanic, and 9.1% white). LARC was not used as a first-line method in the majority (96.0%), regardless of age, race, and ethnicity; yet nearly half identified a long-acting contraceptive as their method of choice., Conclusions: The findings of this pilot study reveal opportunities to reduce unintended pregnancy through increased LARC use, which may be accomplished by provider and patient education., (© The Author(s) 2014.)

Background: The purpose of this study was to determine whether e-mail contact is a viable method for gathering information from adolescent women about contraceptive use., Study Design: Adolescent women initiating contraception followed in a prospective longitudinal cohort study and who had access to the Internet were randomized to the control or intervention arm and were contacted at 3, 6 and 12 months after enrollment. The control arm completed follow-up surveys in-person or by telephone. The intervention arm received Web-based surveys via e-mail., Results: There were 46 women in each group. Women in both groups were approximately 20 years old, were sexually active minority women, and were in school or employed. While participants in the intervention group initially had lower response rates than those in the control group (59% vs. 91%, respectively), with the addition of traditional follow-up methods, the overall response rates were comparable (94% vs. 91%, respectively)., Conclusions: E-mail follow-up with Web-based surveys was effective amongst adolescent women at risk for unintended pregnancy. This indicates that e-mail contact could be used as a preliminary follow-up strategy to capture a substantial proportion of participants and that standard follow-up can be used as a second-line approach. A two-pronged approach with initial e-mail contact and traditional follow-up for participants who do not respond may be a viable method when evaluating sensitive areas such as contraceptive use., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Women are counseled to avoid becoming pregnant for 12-24 months after bariatric surgery. The aim of this study was to assess contraceptive counseling and use in women who undergo bariatric surgery., Methods: A self-administered survey was completed by women aged 18-45 years at a postoperative clinic visit >2 months after bariatric surgery at an urban teaching hospital., Results: Of the 69 respondents, 94.2% knew to avoid pregnancy for at least 12 months after surgery. However, 16.3% did not use any contraception 2-12 months after surgery. The most common contraceptive methods used were condoms (30.6%) and oral contraceptives (16.3%). Longer-acting reversible contraceptives were used less frequently; for example, only 4% of women used intrauterine devices. Only 21.2% of respondents were referred to an obstetrician/gynecologist for contraceptive counseling., Conclusions: Many women who undergo bariatric surgery are not using very effective contraceptive methods or any contraception. There is a clear opportunity to improve counseling and increase use of more effective contraception in this population.