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“It's Pretty Hard to Tell Your Mom and Dad That You're on a Method”: Exploring How an App Could Promote Adolescents' Communication with Partners and Parent(s) to Increase Self-Efficacy in Long-Acting Reversible Contraception Use

  • Emily B. Shakibnia
    Correspondence
    Address correspondence to: Emily B. Shakibnia, MPH, Heilbrunn Department of Population and Family Health, 722 W 168th Street, New York, NY 10032; Phone: 212-304-5200.
    Affiliations
    Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York
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  • Sarah E. Timmons
    Affiliations
    Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York
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  • Melanie A. Gold
    Affiliations
    Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York

    Section of Adolescent Health, Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Medical Center, New York, New York

    School-Based Health Centers, Center for Community Health and Education, New York-Presbyterian Hospital, New York, New York
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  • Samantha Garbers
    Affiliations
    Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York
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Published:October 09, 2017DOI:https://doi.org/10.1016/j.jpag.2017.09.012

      Abstract

      Study Objective

      Youth-friendly information and support are integral components to promote adolescents' successful use of long-acting reversible contraception (LARC), and smartphone apps offer a promising medium. To inform content development for an app guided by the Health Belief Model, we conducted interviews with adolescent LARC users to assess self-efficacy and experiences with LARC, their communication with partners and parent(s) about LARC, and how apps could support this communication.

      Design, Setting, and Participants

      We conducted semistructured, in-depth interviews with 30 female adolescent LARC users enrolled in urban school-based health centers.

      Interventions and Main Outcome Measures

      Descriptive analyses were used to assess demographic characteristics, experience and comfort communicating with current and future partners and parent(s) about LARC, self-efficacy around LARC, and how app elements could support LARC use.

      Results

      Participants (mean age, 16 years; range, 14-19 years) were predominately Hispanic (77%; n = 23) and black (20%; n = 6). Almost all (97%; n = 29) had told their current partner about their LARC, but of these, only 15 (50%) would feel comfortable talking with a new sexual partner. Most participants (73%; n = 22) had not told their parent(s) about getting a LARC, but many reported they were likely to share app information with their parent(s). Of the few participants who did tell their parent(s), 38% (n = 3) reported that it was difficult to do so. Adolescents described ways in which app use could help initiate conversations with new partners and parent(s).

      Conclusion

      These findings suggest the potential of a theory-based smartphone app to meet adolescent LARC users' information and support needs. The app should include information on strategies for communicating with future partners and parent(s).

      Key Words

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