Evaluating long-acting reversible contraception adherence among adolescent girls

Lauren Camille Jackson, The University of Texas School of Public Health


This report provides insight on why adolescent girls do not initiate and adhere to long-acting reversible contraception (LARC) methods and why these trends are problematic. These contraception methods include intrauterine devices (IUDs) and contraceptive implants and are advantageous primarily because they last for 3-10 years, are highly effective in preventing pregnancy, and do not require users to practice regular habits like remembering to take oral contraceptives at the same time every day. While associations like the American College of Obstetricians and Gynecologists have recommended these methods as the first-line contraceptive options for adolescent women, the initiation of these methods has been low among adolescents. This is problematic as teen pregnancy remains high in the United States compared with other developed countries and results in not only billions of dollars in costs for social and health services but also disparate health and social outcomes for teen parents and their children.^ In addition to providing a literature review on factors impacting LARC initiation and adherence, this report outlines potential solutions for increasing LARC initiation and adherence among adolescents. The solutions proposed to address this policy challenge include: • Increase funding for free and low-cost LARC programs and contraceptive healthcare • Increase provider training for LARC insertion and education on LARC methods • Increase the practice of counseling patients on LARC methods and associated benefits. ^ This report presents findings from data collected from People’s Community Clinic in Austin, Texas. This section includes information from interviews with clinic staff, descriptive statistics based on a retrospective chart review of adolescent patients’ electronic medical records (EMR), and regression results on factors impacting LARC adherence. The results show that irregular bleeding, desiring pregnancy or becoming pregnant, and experiencing any side effects are statistically significant determinants of adolescent LARC adherence. The report concludes with a discussion of these findings, suggestions for future research on LARC methods, and an outline for future survey research at People’s Community Clinic.^

Subject Area

Health sciences|Public health|Public policy

Recommended Citation

Jackson, Lauren Camille, "Evaluating long-acting reversible contraception adherence among adolescent girls" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10127432.