How Can We Address What We Do Not Measure? A Systematic Scoping Review of the Measurement and Operationalization of Social Determinants of Health Research on Long-Acting Reversible Contraceptive among Adolescents in the US
Abstract
:1. Introduction
1.1. Sexual and Reproductive Health of Adolescents in the United States
1.2. Long-Acting Reversible Contraceptives
1.3. Barriers to LARC Access for Adolescents and Young Adults
1.4. LARCs and Disparities
- The notion that LARC can solely mitigate unintended pregnancies and thus poverty;
- The clinical emphasis of LARC over all other forms of contraceptives;
- The disregard of the historical association between LARC promotion and racism and eugenics [38].
1.4.1. LARCs as a Means to Ameliorate Social Ailments
1.4.2. Reproductive Coercion and LARC Promotion
1.5. Social Determinants of Health and LARCs
1.6. Study Purpose
2. Materials and Methods
3. Results
3.1. Study Characteristics
3.2. Age
3.3. Race & Ethnicity
3.4. Gender, Sex, and Sexuality
3.5. Social Determinants of Health
4. Discussion
4.1. Race and Ethnicity
- A.
- The purposeful study design (e.g., noting the limitations of using racial categories;
- B.
- A hypothesis-driven analysis (e.g., not assuming race is a driving factor relevant to the study hypothesis);
- C.
- Not pathologizing or medicalizing race (e.g., not using white as a reference group, which can normalize the idea that non-white groups are “other”) and;
- D.
- Acknowledging intersectional identities (e.g., examining models within racial groups [72].
4.2. Gender, Sex, and Sexuality
4.3. Social Determinants of Health
4.4. Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
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Study Name | First Author, Year | US State, BEA * Region | Study Design | Sample Size | Age Range | LARC Methods Examined | Source of Participants | Operationalization of Race and/or Ethnicity |
---|---|---|---|---|---|---|---|---|
Impact of the Rochester LARC Initiative on adolescents’ utilization of long-acting reversible contraception | Aligne, 2020 | National in scope/Multiple regions | Quantitative | Not specifically listed though based on national sample sizes it would theoretically be combined 2013 and 2017 = 28,348 | “High school students” | Defined as “LARC” | Secondary data from the national Youth Risk Behavior Surveillance System (YRBSS) | Race/Ethnicity: White; African-American; Hispanic or Latino |
Retrospective Review of Intrauterine Device in Adolescent and Young Women | Alton, 2012 | Kentucky; Southeast Region | Quantitative | 233 | menarche to 21 years | Hormonal IUD, Non-hormonal IUD | Pediatric and Adolescent gynecology private practice, a Title X clinic, and community based, grant funded clinic serving a high risk teen population. | Not reported |
Will it Hurt? The Intrauterine Device Insertion Experience and Long-Term Acceptability Among Adolescents and Young Women | Callahan, 2019 | Massachusetts; New England Region | Quantitative | 95 | 13–21 years | Hormonal IUD, Non-hormonal IUD | Boston Children’s Hospital and Cambridge Health Alliance | Race: Black; White; Asian; Other; Not Reported; Ethnicity: Hispanic/Latino; Not Hispanic/Latino; Other |
The Impact of an Adolescent Gynecology Provider on Intrauterine Device and Subdermal Contraceptive Implant Use Among Adolescent Patients | Crain, 2019 | West Virginia; Southeast Region | Quantitative | 2401 | 13–24 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Academic Practice and Title X funded patients | Not reported |
Long-Acting Reversible Contraception Counseling and Use for Older Adolescents and Nulliparous Women | Gibbs, 2016 | California, Colorado, Connecticut, Florida, Hawaii, Idaho, Michigan, Minnesota, New Jersey, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, and Washington; National in scope/multiple regions | Quantitative | 1500 | 18–25 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Planned Parenthood health centers serving low-income, diverse patient populations | Race/Ethnicity: White; Hispanic; Black; Other |
Follow-Up Care and 6-Month Continuation Rates for LongActing Reversible Contraceptives in Adolescents and Young Adults: A Retrospective Chart Review | Jones, 2020 | Pennsylvania; Mideast Region | Quantitative | 177 | 13–23 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Urban adolescent specialty care clinic | Race/Ethnicity: non-Hispanic White, non-Hispanic Black, Hispanic or Latino, Other |
Intrauterine Contraception in Adolescents and Young Women: A Descriptive Study of Use, Side Effects, and Compliance | Lara-Torre, 2011 | Virginia; Southeast Region | Quantitative | 89 | 22 years or younger | Hormonal IUD, Non-hormonal IUD | An urban residency program OB/GYN clinic | Not labeled as Race or Ethnicity: Caucasian, African American, Hispanic |
Acceptance of long-acting reversible contraceptive methods by adolescent participants in the Contraceptive CHOICE Project | Mestad, 2011 | Missouri; Plains Region | Quantitative | 5086 | 14–20 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | University-affiliated clinics, two facilities providing abortion services, and community clinics that provide family planning, obstetric, gynecologic, and/or primary care | Race: Black, White, Other; Ethnicity: Hispanic (y/n) |
Improving LARC Access for Urban Adolescents and Young Adults in the Pediatric Primary Care Setting | Onyewuchi, 2019 | Maryland; Mideast Region | Quantitative | 104 | 13–24 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | University Pediatric Clinic | Race/ethnicity: Black, White, Hispanic, Other |
Game change in Colorado: Widespread use of long-acting reversible contraceptives and rapid decline in births among young, low-income women. Perspectives on sexual and reproductive health | Ricketts, 2014 | Colorado; Rocky Mountain Region | Quantitative | 48,740 | 15-24 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Title X-funded Clinics | Race: White, Black, Asian/Pacific Islander, American Indian/Native Alaskan, Other, Unknown; |
Vital Signs: Trends in Use of Long-Acting Reversible Contraception Among Teens Aged 15–19 Years Seeking Contraceptive Services—United States, 2005–201 | Romero, 2015 | National in scope/multiple regions | Quantitative | 616,148 | 15–19 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Family Planning Annual Report, United States | Not Reported |
Urban adolescents and young adults’ decision-making process around selecting intrauterine contraception | Rubin, 2016 | New York; Mideast Region | Qualitative | 27 | 16–25 years | Hormonal IUD, Non-hormonal IUD | Outpatient adolescent medicine clinic located within an academic children’s hospital | Ethnicity only: Latina |
Integrating Long-Acting Reversible Contraception Services into New York City School-Based Health Centers: Quality Improvement to Ensure Provision of Youth-Friendly Services | Sangraula, 2016 | New York; Mideast Region | Qualitative | 18 | 15–19 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | School Based Health Centers | Not measured |
Promotion of Long-Acting Reversible Contraception Among Adolescents and Young Adults | Santibenchakul, 2019 | Hawai’i; Far West Region | Quantitative | 450 visits | 14–25 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Obstetrics and Gynecology clinic | Race: Asian, Pacific Islander, White, Native Hawaiian, Other; Ethnicity: Hispanic or Latino; not Hispanic or Latino; not documented |
Adolescent Experiences With Intrauterine Devices: A Qualitative Study | Schmidt, 2015 | Missouri; Plains Region | Qualitative | 43 | 14–19 years | Hormonal IUD, Non-hormonal IUD | University based clinic in the Contraceptive CHOICE pilot project | Race/Ethnicity: Latina, African American, White, Other |
Pediatric Provider Education and Use of Long-Acting Reversible Contraception in Adolescents | Smith, 2019 | Massachusetts; Mideast Region | Quantitative | 7331 | 15–21 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Large health system | Not Reported |
Provider and health system factors associated with usage of long-acting reversible contraception in adolescents. | Smith, 2017 | Massachusetts; Mideast Region | Quantitative | 5363 | 15–21 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Multiple sites (clinics, hospitals) | Not Reported |
Adolescents’ Acceptance of Long-Acting Reversible Contraception After an Educational Intervention in the Emergency Department: A Randomized Controlled Trial | Vayngortin, 2020 | California; Far West Region | Quantitative | 79 | 14–21 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Urban pediatric emergency department | Ethnicity only: African-American, Hispanic, Multi-Ethnic, Caucasian, Asian/Pacific Islander |
Use of the Intrauterine Device Among Adolescent and Young Adult Women in the United States From 2002 to 2010 | Whitaker, 2013 | National in scope/multiple regions | Quantitative | 4684 | 15–24 years | Hormonal IUD, Non-hormonal IUD, Subdermal contraceptive implant | Secondary data from the National Survey of Family Growth (NSFG) | Race/Ethnicity: White/non-Hispanic, Black/non-Hispanic, Hispanic, Other/Multiracial |
Dahlgren and Whitehead Model Levels | Social Determinants |
---|---|
General socio-economic, cultural, and environmental conditions | Geographical area [52] |
Public LARC education [17] | |
State with Medicaid expansion [51] Private funding for LARC [39,61,62] WIC usage in the area * [39] Internet and media [56] | |
Living and working conditions | Health services [39,51,52,54,55,56,57,58,59,60,61,62,64,65,66,67] |
Health insurance/payor status ** [39,51,53,54,55,56,61,62,63,64] Education [17,53,56,61,62] Income/Federal Poverty Level [39,53,61,62] | |
Social and community networks | Marital/partner status [51,53,61,64] Sex partner opinion/experience [56,60] Social support and influence [56,57] Religion [53] |
Individual lifestyle factors | Substance use (e.g., tobacco, alcohol, drugs) [60] Sexual and reproductive factors [51,53,64,67] |
Age, sex, and constitutional factors (nonbiological, physiologic, or genetic) | Age 17, [39,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67] Sex 17, [39,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67] |
Race and/or ethnicity [17,39,51,53,54,55,56,60,61,62,63,64,65] | |
Biological [17,39,51,53,54,55,56,57,59,60,61,62,63,64,65,67] Born outside of the US [53] |
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Poehling, C.; Mary Downey, M.; Gwan, A.P.; Cannady, S.; Ismail, O. How Can We Address What We Do Not Measure? A Systematic Scoping Review of the Measurement and Operationalization of Social Determinants of Health Research on Long-Acting Reversible Contraceptive among Adolescents in the US. Adolescents 2023, 3, 240-258. https://doi.org/10.3390/adolescents3020018
Poehling C, Mary Downey M, Gwan AP, Cannady S, Ismail O. How Can We Address What We Do Not Measure? A Systematic Scoping Review of the Measurement and Operationalization of Social Determinants of Health Research on Long-Acting Reversible Contraceptive among Adolescents in the US. Adolescents. 2023; 3(2):240-258. https://doi.org/10.3390/adolescents3020018
Chicago/Turabian StylePoehling, Catherine, Margaret Mary Downey, Anwei Polly Gwan, Sarah Cannady, and Olivia Ismail. 2023. "How Can We Address What We Do Not Measure? A Systematic Scoping Review of the Measurement and Operationalization of Social Determinants of Health Research on Long-Acting Reversible Contraceptive among Adolescents in the US" Adolescents 3, no. 2: 240-258. https://doi.org/10.3390/adolescents3020018