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Contraception is widely used in the United States, and nurses in all settings may encounter patients who are using or want to use contraceptives. Nurses may be called on to anticipate how family planning intersects with other health care services and provide patients with information based on the most current evidence. This article describes key characteristics of nonpermanent contraceptive methods, including mechanism of action, correct use, failure rates with perfect and typical use, contraindications, benefits, side effects, discontinuation procedures, and innovations in the field. We also discuss how contraceptive care is related to nursing ethics and health inequities.

Objective Despite growing consensus about the clinical value of preconception care (PCC), gaps and disparities remain in its delivery. This study aimed to examine the factors influencing behavior of health care providers around PCC in outpatient clinical settings in the United States. Methods Twenty health care providers who serve people of reproductive age were interviewed using semi-structured interviews. Data was coded based on a modified Theoretical Domains Framework and analyzed using deductive content analysis. Results We interviewed eight family medicine physicians, four obstetricians/gynecologists, seven nurse practitioners, and one nurse midwife. Overall, we found a wide variety in practices and attitudes towards PCC. Barriers and challenges to delivering PCC were shared across sites. We identified six themes that influenced provider behavior around PCC: (1) lack of knowledge of PCC guidelines, (2) perception of lack of preconception patient contact, (3) pessimism around patient 'compliance,' (4) opinion about scope of practice, (5) clinical site structure, and (6) reliance on the patient/provider relationship. Conclusions for Practice Overall, our findings call for improved provider understanding of PCC and creative incorporation into current health care culture and practice. Given that PCC-specific visits are perceived by some as outside the norm of clinical offerings, providers may need to incorporate PCC into other encounters, as many in this study reported doing. We amplify the call for providers to understand how structural inequities may influence patient behavior and the value of standardized screening, within and beyond PCC, as well as examination of implicit and explicit provider bias., Author(s): Erin C. Nacev [sup.1] [sup.2] , Madelyne Z. Greene [sup.3] , Mireya P. Taboada [sup.1] [sup.4] , Deborah B. Ehrenthal [sup.5] [sup.6] Author Affiliations: (1) grid.14003.36, 0000 0001 2167 [...]

Although sexual minority women (SMW) are at risk for cervical cancer and sexually transmitted infections (STIs), they may not seek preventative sexual and reproductive health care at the same rates as their heterosexual peers. We conducted a qualitative descriptive study of 22 adult SMW, a subsample of participants enrolled in the Chicago Health and Life Experiences of Women study. The aim was to describe the sexual and reproductive health literacy of this community sample based on qualitative themes, using an integrated model of health literacy. This model considers not only access to information but also understanding, appraisal, and application of information. We found that family of origin, health care providers, and school-based sexual education were the most important sources of sexual and reproductive health information. Participants described their understanding, appraisal, and application of sexual and reproductive health information as interdependent concepts. Pap test literacy and decision making were strongly independent, with SMW seeking various sources of information, or were driven by health care providers, with SMW following instructions and trusting provider advice. STI-related literacy hinged on whether the participant perceived SMW as at risk for STIs. Our findings reinforce that simply having access to information is insufficient to enact health behaviors that reflect full literacy. Findings have implications for health care providers, who should provide evidence-based recommendations for their SMW clients, and for public health practitioners and educators, who could make sexual health education more inclusive of and specific to the needs of SMW.

While there is growing documentation of pregnancy among sexual minority women, little research has focused on their perceptions and experiences of conflict between sexual minority identity and pregnancy. Because of this, this study used Social Identity Theory and qualitative descriptive analysis to explore the following questions: do sexual minority women perceive sexual minority identity and pregnancy as in conflict; and if so, from where does this conflict arise and how do sexual minority women experience it? Participants included 21 lesbian, gay, bisexual, queer and other non-heterosexual cisgender women, a third of whom had previously been pregnant. Themes captured internally located conflict, including participants who saw pregnancy as irrelevant and those who experienced pregnancy as acceptable for sexual minority women; imposed conflict from healthcare contexts, including both health provider assumptions and imposed conflict on reproductive autonomy; and ambivalence. Overall, few participants noted internalised conflict between their sexual minority identity and pregnancy. Instead, sexual minority women experienced ambivalence or imposed conflict between their sexual minority identities and pregnancy from their health providers, although this imposed conflict was not limited to sexual orientation. [ABSTRACT FROM AUTHOR]

This study investigates within‐group differences in body image concerns among sexual minority women and their related association with eating disorders and depression. Cross‐sectional data were collected in 2017 and analysed in 2020 from 201 sexual minority women in the United States. Latent profile analyses and post hoc comparison analyses were conducted to investigate within‐group variability in body image concerns and to understand their impact on depressive and eating disorder symptoms. Results suggested that a 5‐class solution best fit the data, with five distinct profiles emerging in patterns of interoceptive awareness, sociocultural attitudes toward appearance, body shame, body surveillance and appearance anxiety. Significant differences in mean scores of depressive and eating disorder symptomatology emerged among the profiles; groups that reported low interoceptive awareness and high body image concerns experienced greater levels of eating disorder and depressive symptoms, compared to groups with average or higher levels of interoceptive awareness and average or lower body image concerns. Results underscore the significant within‐group variability that exists for sexual minority women with regard to the prevalence of body image concerns, depressive symptoms and eating disorder symptoms. Efforts that aim to increase interoceptive awareness (for example, mindfulness) alongside strategies aimed at addressing negative body image concerns may be particularly effective avenues for future depression and eating disorder prevention in this diverse group. Our reporting adheres to the STROBE research reporting checklist. [ABSTRACT FROM AUTHOR]

Introduction: Abortion is a polarizing social and medical issue, even among physicians. Though the public may expect physicians to hold purely scientific attitudes about abortion, their attitudes and behaviors are just as strongly informed by social and political factors as the public's. In a recent survey study of physicians at an academic medical center about their abortion attitudes, most reported strong support for abortion access. However, more were unwilling to consult in abortion-related cases, and many perceived little or no professional connection to abortion and were reticent to publicly advocate for their position., Methods: In order to investigate the nuances in physicians' abortion attitudes, we analyzed the open-ended, qualitative responses provided by physicians at the end of a quantitative survey using modified concept mapping procedures and theme generation., Results: Two hundred twenty-two open-ended responses resulted in 487 data units. We categorized respondents' comments into 2 main groups: attempts to depersonalize, or distance oneself, from abortion and expressions of nuance or ambivalence about abortion. Ambivalence and nuance in abortion attitudes centered around multiple factors that varied from individual to structural., Conclusions: Our findings support previous literature suggesting that physicians' abortion attitudes are not binary and add that nuanced attitudes may be perceived as unwelcome. Acknowledging ambivalence and addressing physicians' tendency to depersonalize abortion could result in more honest, open, and nuanced discourse and contribute to addressing structural issues that result in poor health outcomes, achieving broader reproductive justice goals, and greater access to abortion services., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)

Cervical cancer screening is a critical preventive healthcare service for all women. Sexual minority women (SMW) in the United States experience multiple health disparities including decreased access to and use of cervical cancer screening. The mechanisms driving these disparities are not clear and SMW with multiple marginalized identities may be more likely to miss recommended cervical cancer screening. This study aimed to identify subgroups of SMW that are more and less likely to be screened for cervical cancer according to American Cancer Society guidelines. We used cross-sectional data from the latest (2010-2012) wave of the Chicago Health and Life Experiences of Women (CHLEW) Study (N = 691). Informed by intersectionality theory, we performed classification and regression tree (CART) modeling to construct a data-driven, predictive model of subgroups of SMW who were more and less likely to receive guideline-recommended screening. Notably, the CART model did not include commonly tested variables such as race/ethnicity or level of income or education. The model did identify subgroups with low likelihood of receiving screening and several novel variables that may be important in understanding SMW's use of cervical cancer screening; lifetime number of sexual partners, age at drinking onset, childhood physical abuse, and internalized homonegativity. Our results point to the importance of early life experiences and identity development processes in shaping patterns of preventive healthcare use among adult SMW. Our analysis also demonstrated the potential value of CART modeling techniques for evaluating how multiple variables interact in complex ways to predict cervical cancer screening.