Perceptions of LARC Among AYA With Chronic Illness

Summary

The investigators aim to perform a qualitative study exploring attitudes and perceived barriers to Long Acting Reversible Contraception (LARC), both implants and IUDs, among adolescent and young adults (AYA) with chronic illness at CHLA. While the literature examining barriers to LARC uptake is growing, its focus has been on older women and women who are not living with chronic illness. There remains a significant gap in the understanding of:

1. What adolescents and young adults from ethnically diverse, economically underserved communities know about LARCs
2. If and how LARCs fit into their considerations and decision making about contraception choices
3. Perceived barriers to LARC among AYA with chronic medical conditions
4. Information, perceptions, experiences that inform choices that may be unique to AYA living with chronic conditions

Research Objectives

1. Explore the impact of the experience of living with chronic medical conditions on AYA patient attitudes toward and acceptance of LARCs
2. Identify AYA patient concerns and perceptions related to historical coercion and reproductive injustice experienced by minority communities that may reduce acceptance of LARC
3. Explore the relationship between patients' perception of pediatric subspecialty care providers' attitudes regarding sexual health and contraception guidance and patients' attitudes toward and acceptance of LARC
4. Identify factors related to patient's age, family's values, and medical condition, as well as historical events or legacies that may impact preference of implant vs intra-uterine device (IUD), independent of safety/medical contraindications, if choosing a LARC method.
5. Explore other social, cultural or psychological factors that influence perception and represent barriers to LARC access

Hypotheses

1. The impact of chronic illness on AYA sense of bodily autonomy (including self-concept, history of other medical procedures, and concerns around mortality) reduces the attractiveness of LARC methods.
2. The intersectionality of multiple oppressions, including racism, xenophobia, sexism, and historical reproductive coercion and injustice implicitly reduce the attractiveness of LARC methods for AYA patients from minority communities with chronic medical conditions at CHLA.
3. Pediatric subspecialty providers' attitudes about sex, and comfort with providing patient-centered contraception counseling, as perceived by AYA patients, impact AYA patient attitudes towards and acceptance of LARC.
4. Preference of implant vs. IUD is related to patient's age, family values, and type of medical condition, as well as their knowledge of historical events related to contraception in their community, independent of safety/medical contraindications.
5. Additional perceived barriers, including fear or skepticism about LARC conferred by trusted sources of information such as family or social media, reduce the attractiveness and acceptance of LARC by AYA with chronic medical conditions

Conditions

• Chronic Conditions, Multiple

Interventions

OTHER

No intervention being administered

No intervention will be administered. Each patient will participate in a qualitative focus group discussing their beliefs/attitudes about their reproductive health and birth control

Sponsors & Collaborators

• Organon

  collaborator INDUSTRY

• Children's Hospital Los Angeles

  lead OTHER

Principal Investigators

• Claudia Borzutzky, MD · Children's Hospital Los Angeles

• Ellen Iverson, MPH · Children's Hospital Los Angeles

Eligibility

Min Age

16 Years

Max Age

21 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-04-16

Primary Completion

2022-04-07

Completion

2022-04-07

Countries

• United States

Study Locations