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[PMID]:28742443
[Au] Autor:Smith E; Charantimath US; Wilson SF; Hoffman MK
[Ad] Endereço:a Department of Obstetrics and Gynecology , Christiana Care Health System , Newark , DE, USA.
[Ti] Título:Family planning in Southern India: A survey of women's attitudes.
[So] Source:Health Care Women Int;38(10):1022-1033, 2017 Oct.
[Is] ISSN:1096-4665
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Women were recruited from villages in the Belgaum district of India. Members of the research team obtained consent and led 58 interviews in the local languages. Participants were asked questions covering topics related to postpartum contraceptive counseling, knowledge, and experience; postpartum sexual practice; birth spacing desire and counseling; and interest in long-acting reversible contraceptives (LARCs). Women generally desired 3 years of birth spacing. A majority did not receive counseling regarding postpartum contraception during the prenatal period, although most would have liked to have received such counseling. Those who had made a contraceptive plan during the prenatal period had an odds ratio of 25.2 (95% CI 4.9-128.6, p = 0.00001) for using postpartum contraception. Influences on contraceptive decisions primarily came from friends and family, while information from medical providers was not a major influence. Most women did not believe they could make their own decisions regarding contraception use, but those who did had an adjusted odds ratio of 56 (95% CI 3.4-9161, p = 0.0047) of utilizing postpartum contraception. Women generally liked the idea of LARCs. A large majority of the women surveyed (89.66%) liked the idea of a subdermal contraceptive implant, a method currently unavailable in this region. Ultimately, the women surveyed do have healthy attitudes and goals regarding birth spacing but few utilize effective contraception in order to meet their goals. Further efforts in counseling as well as availability of a wider variety of contraceptive methods, including the subdermal contraceptive implant, may decrease the disparity between desires and practices.
[Mh] Termos MeSH primário: Comportamento Contraceptivo
Anticoncepção/métodos
Serviços de Planejamento Familiar/métodos
Conhecimentos, Atitudes e Prática em Saúde
[Mh] Termos MeSH secundário: Adolescente
Adulto
Intervalo entre Nascimentos
Anticoncepção/utilização
Aconselhamento
Serviços de Planejamento Familiar/recursos humanos
Feminino
Seres Humanos
Índia
Período Pós-Parto
Saúde da População Rural
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1080/07399332.2017.1356306


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[PMID]:29370220
[Au] Autor:Jayaweera RT; Ngui FM; Hall KS; Gerdts C
[Ad] Endereço:Ibis Reproductive Health, Oakland, California, United States of America.
[Ti] Título:Women's experiences with unplanned pregnancy and abortion in Kenya: A qualitative study.
[So] Source:PLoS One;13(1):e0191412, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Safe and legal abortions are rarely practiced in the public health sector in Kenya, and rates of maternal mortality and morbidity from unsafe abortion is high. Little is known about women's experiences seeking and accessing abortion in informal settlements in Nairobi, Kenya. METHODS: Seven focus group discussions were conducted with a total of 71 women and girls recruited from an informal settlement in Nairobi. The interview guide explored participants' perceptions of unplanned pregnancy, abortion, and access to sexual and reproductive health information in their community. Thematic analysis of the focus group transcripts was conducted using MAX QDA Release 12. RESULTS: Participants described a variety of factors that influence women's experiences with abortion in their communities. According to participants, limited knowledge of sexual and reproductive health information and lack of access to contraception led to unplanned pregnancy among women in their community. Participants cited stigma and loss of opportunities that women with unplanned pregnancies face as the primary reasons why women seek abortions. Participants articulated stigma as the predominant barrier women in their communities face to safe abortion. Other barriers, which were often interrelated to stigma, included lack of education about safe methods of abortion, perceived illegality of abortion, as well as limited access to services, fear of mistreatment, and mistrust of health providers and facilities. CONCLUSIONS: Women in informal settlements in Nairobi, Kenya face substantial barriers to regulating their fertility and lack access to safe abortion. Policy makers and reproductive health advocates should support programs that employ harm reduction strategies and increase women's knowledge of and access to medication abortion outside the formal healthcare system.
[Mh] Termos MeSH primário: Aborto Induzido
Gravidez não Planejada
[Mh] Termos MeSH secundário: Aborto Induzido/psicologia
Acesso à Informação
Adolescente
Adulto
Comportamento Contraceptivo
Feminino
Grupos Focais
Educação em Saúde
Acesso aos Serviços de Saúde
Seres Humanos
Comportamento de Busca de Informação
Quênia
Gravidez
Gravidez não Planejada/psicologia
Comportamento Reprodutivo
Estigma Social
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191412


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[PMID]:29315327
[Au] Autor:Wekesa E; Askew I; Abuya T
[Ad] Endereço:School of Humanities and Social Sciences, South Eastern Kenya University, Kitui, Kenya.
[Ti] Título:Ambivalence in pregnancy intentions: The effect of quality of care and context among a cohort of women attending family planning clinics in Kenya.
[So] Source:PLoS One;13(1):e0190473, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: Ambivalence in pregnancy intentions is well-documented in sub-Saharan African (SSA) settings and has been associated with inconsistent use of contraception, thereby exposing women using contraception to the possibility of unintended pregnancies. A better understanding of the potential role for client counseling interventions in enabling women to achieve their pregnancy intentions is essential for aiding program efforts to reduce unintended pregnancies. OBJECTIVE: To measure ambivalence in pregnancy intentions longitudinally and determine its association with the quality of care received, controlling for demographic, socio-economic and contextual factors among a cohort of family planning (FP) clients in Kenya. METHODS: This paper uses data drawn from a prospective cohort study of FP clients to investigate the relationship between the quality of care received during FP service delivery and the decisiveness of their pregnancy intentions over time. The study tests the hypothesis that higher quality of care enables women to be less ambivalent about their pregnancy intentions. Binary logistic regression with random effects and multinomial logistic regression were used to assess the predictive effect of the quality of care received by a woman on the decisiveness or ambivalence of her pregnancy intentions, and on any shifts in ambivalence over time, controlling for background characteristics. The study recruited 1,957 women aged 15-49 years attending twelve family planning clinics in four counties in Central Kenya; of these, 1,053 women were observed for four rounds of data collection over a period of 24 months and form the sample for analysis. FINDINGS: A substantial proportion (43%) of women expressed ambivalence about their intentions to become pregnant at some point during the study period, while over half (57%) remained unequivocal throughout the study. Almost one third of women (31%) shifted from being unequivocal to ambivalent and 12% shifted from ambivalence to being unequivocal. Women experiencing higher quality of care have lower odds of ever expressing ambivalence and higher odds of remaining unequivocal over time, net of other factors. Quality of care was not associated with a shift in ambivalence over time. CONCLUSION: FP programs offering higher quality of care are likely to support women to be more decisive in their pregnancy intentions. Improving the quality of care can contribute to reduced ambivalence and consequently reduced likelihood of unintended pregnancy among contraceptive users. This study provides further evidence of the benefits gained through providing high quality services. TRIAL REGISTRATION: ClinicalTrials.gov NCT01694862.
[Mh] Termos MeSH primário: Gravidez não Planejada/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Comportamento Contraceptivo/estatística & dados numéricos
Feminino
Seres Humanos
Meia-Idade
Gravidez
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190473


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[PMID]:29351328
[Au] Autor:Fang D; Sun R; Wilson JR
[Ad] Endereço:Department of Agricultural Economics and Agribusiness, University of Arkansas, Fayetteville, AR, United States of America.
[Ti] Título:Joint modeling of correlated binary outcomes: The case of contraceptive use and HIV knowledge in Bangladesh.
[So] Source:PLoS One;13(1):e0190917, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recent advances in statistical methods enable the study of correlation among outcomes through joint modeling, thereby addressing spillover effects. By joint modeling, we refer to simultaneously analyzing two or more different response variables emanating from the same individual. Using the 2011 Bangladesh Demographic and Health Survey, we jointly address spillover effects between contraceptive use (CUC) and knowledge of HIV and other sexually transmitted diseases. Jointly modeling these two outcomes is appropriate because certain types of contraceptive use contribute to the prevention of HIV and STDs and the knowledge and awareness of HIV and STDs typically lead to protection during sexual intercourse. In particular, we compared the differences as they pertained to the interpretive advantage of modeling the spillover effects of joint modeling HIV and CUC as opposed to addressing them separately. We also identified risk factors that determine contraceptive use and knowledge of HIV and STDs among women in Bangladesh. We found that by jointly modeling the correlation between HIV knowledge and contraceptive use, the importance of education decreased. The HIV prevention program had a spillover effect on CUC: what seemed to be impacted by education can be partially contributed to one's exposure to HIV knowledge. The joint model revealed a less significant impact of covariates as opposed to both separate models and standard models. Additionally, we found a spillover effect that would have otherwise been undiscovered if we did not jointly model. These findings further suggested that the simultaneous impact of correlated outcomes can be adequately addressed for the commonality between different responses and deflate, which is otherwise overestimated when examined separately.
[Mh] Termos MeSH primário: Comportamento Contraceptivo
Infecções por HIV/prevenção & controle
Conhecimentos, Atitudes e Prática em Saúde
[Mh] Termos MeSH secundário: Adolescente
Adulto
Bangladesh/epidemiologia
Criança
Preservativos/utilização
Comportamento Contraceptivo/estatística & dados numéricos
Política de Planejamento Familiar
Feminino
Infecções por HIV/epidemiologia
Inquéritos Epidemiológicos/estatística & dados numéricos
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Modelos Estatísticos
Fatores de Risco
População Rural
Doenças Sexualmente Transmissíveis/prevenção & controle
População Urbana
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190917


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[PMID]:29240392
[Au] Autor:Sweet L
[Ti] Título:THE LOW DOWN ON LONG-ACTING REVERSIBLE CONTRACEPTIVES IN PRIMARY HEALTHCARE.
[So] Source:Aust Nurs Midwifery J;24(2):42, 2016 08.
[Is] ISSN:2202-7114
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Effective primary healthcare (PHC) is meant to support people to manage their health issues in the community, resulting in less hospitalization, fewer health inequalities and better health outcomes for all people. This being said, unplanned pregnancy remains an urgent and pressing key health issue in Australia.
[Mh] Termos MeSH primário: Contracepção Reversível de Longo Prazo
Gravidez não Planejada
Atenção Primária à Saúde
[Mh] Termos MeSH secundário: Austrália
Comportamento Contraceptivo
Feminino
Seres Humanos
Guias de Prática Clínica como Assunto
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:27773713
[Au] Autor:Karpilow QC; Thomas AT
[Ad] Endereço:Child Trends, Bethesda, MD.
[Ti] Título:Reassessing the importance of long-acting contraception.
[So] Source:Am J Obstet Gynecol;216(2):148.e1-148.e14, 2017 Feb.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Several recent studies have highlighted the need for greater use of long-acting contraception. The most influential of these studies is the Contraceptive CHOICE Project, which was credited with substantially reducing participants' pregnancy risk by increasing their use of long-acting methods such as intrauterine devices and subdermal implants. However, because participants' rates of nonuse and condom use fell to zero at the outset of the intervention, it is possible that sizable pregnancy reductions could still have been achieved if enrollees had chosen shorter-acting, female-controlled methods such as oral contraception. OBJECTIVE: The objective of the study was to estimate the proportion of the CHOICE Project's fertility impacts that could have been achieved without any increase in long-acting method use. STUDY DESIGN: The FamilyScape 3.0 microsimulation model was used to estimate CHOICE's impact on pregnancy risk and to simulate the counterfactual effect of moving all nonusers and condom users onto shorter-acting, female-controlled methods. FamilyScape models the sexual and contraceptive behaviors of women in the United States between 2006 and 2010, which is the period when CHOICE was implemented. RESULTS: Nearly three quarters of the CHOICE intervention's effects on pregnancy risk could have been achieved if participants had chosen shorter-acting, female-controlled methods over long-acting methods. CONCLUSION: Prioritizing the adoption of long-acting contraception may not be the most advisable strategy for reducing unintended pregnancy. The most impactful interventions will likely be those that increase the use of female-controlled methods, long-acting or otherwise.
[Mh] Termos MeSH primário: Comportamento Contraceptivo/estatística & dados numéricos
Anticoncepção/métodos
Anticoncepcionais Femininos/uso terapêutico
Dispositivos Intrauterinos/utilização
[Mh] Termos MeSH secundário: Simulação por Computador
Anticoncepcionais Orais/uso terapêutico
Preparações de Ação Retardada
Implantes de Medicamento
Feminino
Seres Humanos
Modelos Teóricos
Gravidez
Gravidez não Planejada
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptive Agents, Female); 0 (Contraceptives, Oral); 0 (Delayed-Action Preparations); 0 (Drug Implants)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161107
[St] Status:MEDLINE


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[PMID]:29176849
[Au] Autor:Surie D; Yuhas K; Wilson K; Masese LN; Shafi J; Kinuthia J; Jaoko W; McClelland RS
[Ad] Endereço:Department of Medicine, University of Washington, Seattle, United States of America.
[Ti] Título:Association between non-barrier modern contraceptive use and condomless sex among HIV-positive female sex workers in Mombasa, Kenya: A prospective cohort analysis.
[So] Source:PLoS One;12(11):e0187444, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: As access to antiretroviral therapy in sub-Saharan Africa continues to expand, more women with HIV can expect to survive through their reproductive years. Modern contraceptives can help women choose the timing and spacing of childbearing. However, concerns remain that women with HIV who use non-barrier forms of modern contraception may engage in more condomless sex because of their decreased risk of unintended pregnancy. We examined whether non-barrier modern contraceptive use by HIV-positive female sex workers was associated with increased frequency of recent condomless sex, measured by detection of prostate-specific antigen (PSA) in vaginal secretions. METHODS: Women who were HIV-positive and reported transactional sex were included in this analysis. Pregnant and post-menopausal follow-up time was excluded, as were visits at which women reported trying to get pregnant. At enrollment and quarterly follow-up visits, a pelvic speculum examination with collection of vaginal secretions was conducted for detection of PSA. In addition, women completed a structured face-to-face interview about their current contraceptive methods and sexual risk behavior at enrollment and monthly follow-up visits. Log-binomial generalized estimating equations regression was used to test for associations between non-barrier modern contraceptive use and detection of PSA in vaginal secretions and self-reported condomless sex. Data from October 2012 through September 2014 were included in this analysis. RESULTS: Overall, 314 women contributed 1,583 quarterly examination visits. There was minimal difference in PSA detection at contraceptive-exposed versus contraceptive-unexposed visits (adjusted relative risk [aRR] 1.28, 95% confidence interval [95% CI] 0.93-1.76). There was a higher rate of self-reported condomless sex at visits where women reported using modern contraceptives, but this difference was not statistically significant after adjustment for potential confounding factors (aRR 1.59, 95% CI 0.98-2.58). CONCLUSION: Non-barrier methods of modern contraception were not associated with increased risk of objective evidence of condomless sex.
[Mh] Termos MeSH primário: Preservativos/utilização
Comportamento Contraceptivo/estatística & dados numéricos
Soropositividade para HIV/epidemiologia
Profissionais do Sexo/estatística & dados numéricos
Comportamento Sexual
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Quênia/epidemiologia
Estudos Prospectivos
Antígeno Prostático Específico/análise
Autorrelato
Vagina/secreção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0187444


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[PMID]:29016515
[Au] Autor:Moniz MH; Gavin LE; Dalton VK
[Ad] Endereço:Department of Obstetrics and Gynecology, the Program on Women's Healthcare Effectiveness Research, and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
[Ti] Título:Performance Measures for Contraceptive Care: A New Tool to Enhance Access to Contraception.
[So] Source:Obstet Gynecol;130(5):1121-1125, 2017 Nov.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Contraception is an essential health service for reducing unintended pregnancy rates, improving health outcomes, and reducing health care costs. However, contraceptive services may not consistently provide access to the full method mix and to patient-centered care. Improving the quality of contraceptive care is a critical strategy to improve contraceptive use, health outcomes, and the patient experience of care. We here describe the three National Quality Forum-endorsed performance measures for contraceptive care, which are intended to monitor 1) provision of most and moderately effective methods, 2) access to long-acting reversible contraception, and 3) provision of most and moderately effective methods and access to long-acting reversible contraception after childbirth. These contraceptive care measures are designed to ensure that contraceptive care is accessible and offers the full spectrum of methods. Payers, health care systems, public agencies, and researchers could all monitor these performance measures for different populations. We describe the crucial role of clinicians in disseminating and using the contraceptive care performance measures for quality improvement. We describe ongoing efforts to improve contraceptive care quality, including the development of measures to monitor other dimensions of quality such as the safety and patient-centeredness of care. Thirty-eight million women at risk of unintended pregnancy are counting on us to improve the quality of family planning care in the United States and ensure that all women have the resources and tools to make free, informed choices about whether and when to become pregnant.
[Mh] Termos MeSH primário: Comportamento Contraceptivo/estatística & dados numéricos
Anticoncepção/normas
Serviços de Planejamento Familiar/normas
Acesso aos Serviços de Saúde/normas
Assistência Centrada no Paciente/normas
[Mh] Termos MeSH secundário: Anticoncepção/métodos
Anticoncepcionais/uso terapêutico
Serviços de Planejamento Familiar/métodos
Feminino
Seres Humanos
Assistência Centrada no Paciente/métodos
Gravidez
Taxa de Gravidez
Gravidez não Planejada
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptive Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002314


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[PMID]:29016506
[Au] Autor:Menke MN; King WC; White GE; Gosman GG; Courcoulas AP; Dakin GF; Flum DR; Orcutt MJ; Pomp A; Pories WJ; Purnell JQ; Steffen KJ; Wolfe BM; Yanovski SZ
[Ad] Endereço:University of Pittsburgh School of Medicine, the University of Pittsburgh Graduate School of Public Health, and the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Weill Cornell University Medical Center, New York, New York; the University of Washington, Seattle, Washington; the Neuropsychiatric Research Institute, Fargo, North Dakota; Brody School of Medicine, East Carolina University, Greenville, North Carolina; Oregon Health & Science University, Portland, Oregon; North Dakota State University, Fargo, North Dakota; and the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
[Ti] Título:Contraception and Conception After Bariatric Surgery.
[So] Source:Obstet Gynecol;130(5):979-987, 2017 Nov.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine contraceptive practices and conception rates after bariatric surgery. METHODS: The Longitudinal Assessment of Bariatric Surgery-2 is a multicenter, prospective cohort study of adults undergoing first-time bariatric surgery as part of routine clinical care at 10 U.S. hospitals. Recruitment occurred between 2005 and 2009. Participants completed preoperative and annual postsurgical assessments for up to 7 years until January 2015. This report was restricted to women 18-44 years old with no history of menopause, hysterectomy, or estrogen and progesterone therapy. Primary outcomes were self-reported contraceptive practices, overall conception rate, and early (less than 18 months) postsurgical conception. Contraceptive practice (no intercourse, protected intercourse, unprotected intercourse, or tried to conceive) was classified based on the preceding year. Conception rates were determined from self-reported pregnancies. RESULTS: Of 740 eligible women, 710 (95.9%) completed follow-up assessment(s). Median (interquartile range) preoperative age was 34 (30-39) years. In the first postsurgical year, 12.7% (95% CI 9.4-16.0) of women had no intercourse, 40.5% (95% CI 35.6-45.4) had protected intercourse only, 41.5% (95% CI 36.4-46.6) had unprotected intercourse while not trying to conceive, and 4.3% (95% CI 2.4-6.3) tried to conceive. The prevalence of the first three groups did not significantly differ across the 7 years of follow-up (P for all >.05); however, more women tried to conceive in the second year (13.1%, 95% CI 9.3-17.0; P<.001). The conception rate was 53.8 (95% CI 40.0-71.1) per 1,000 woman-years across follow-up (median [interquartile range] 6.5 [5.9-7.0] years); 42.3 (95% CI 30.2-57.6) per 1,000 woman-years in the 18 months after surgery. Age (adjusted relative risk 0.41 [95% CI 0.19-0.89] per 10 years, P=.03), being married or living as married (adjusted relative risk 4.76 [95% CI 2.02-11.21], P<.001), and rating future pregnancy as important preoperatively (adjusted relative risk 8.50 [95% CI 2.92-24.75], P<.001) were associated with early conception. CONCLUSIONS: Postsurgical contraceptive use and conception rates do not reflect recommendations for an 18-month delay in conception after bariatric surgery. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT00465829.
[Mh] Termos MeSH primário: Cirurgia Bariátrica/estatística & dados numéricos
Comportamento Contraceptivo/estatística & dados numéricos
Anticoncepção/estatística & dados numéricos
Fertilização
Obesidade/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Cirurgia Bariátrica/métodos
Anticoncepção/métodos
Feminino
Seguimentos
Seres Humanos
Estudos Longitudinais
Período Pós-Operatório
Gravidez
Taxa de Gravidez
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171111
[Lr] Data última revisão:
171111
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002323


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[PMID]:28950721
[Au] Autor:Mesheriakova VV; Tebb KP
[Ad] Endereço:1 Division of Adolescent and Young Adult Medicine UCSF Benioff Children's Hospital University of California, San Francisco, CA, USA.
[Ti] Título:Effect of an iPad-Based Intervention to Improve Sexual Health Knowledge and Intentions for Contraceptive Use Among Adolescent Females at School-Based Health Centers.
[So] Source:Clin Pediatr (Phila);56(13):1227-1234, 2017 Nov.
[Is] ISSN:1938-2707
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The use of effective contraception can decrease the incidence of unplanned pregnancy among adolescents. This study aims to examine the effectiveness of an iPad-based application (app) on improving adolescent girls' sexual health knowledge and on its ability to influence their intentions to use effective contraception. STUDY DESIGN: This was a prospective study of girls aged 12 to 18 years recruited from 3 school-based health centers in California. RESULTS: A total of 120 racially/ethnically diverse participants used the iPad app; 54% were sexually active, with only 26% using effective contraception at baseline. The average score on baseline sexual health knowledge assessment was 58%. After using the app, 68% of the sexually active participants reported intention to use effective contraception in the future, and sexual health knowledge improved significantly to 79% ( P < .001). CONCLUSIONS: This iPad-based app is a promising intervention to educate adolescents about sexual health and support them in selecting an effective contraception method.
[Mh] Termos MeSH primário: Computadores de Mão
Comportamento Contraceptivo/psicologia
Aplicativos Móveis
Serviços de Saúde Escolar/organização & administração
Comportamento Sexual/psicologia
[Mh] Termos MeSH secundário: Adolescente
California
Criança
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1177/0009922816681135



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