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Impact of trust in the health care system on use of long-acting reversible contraception

Rachel Stacey, Medical University of South Carolina, 2012

Project abstract

Background: A high incidence of unintended pregnancy remains a public health challenge, and highly effective methods of contraception remain significantly underused. Increasing the use of long-acting reversible contraception (LARC) immediately post-abortion may reduce the number unintended pregnancies and repeat abortions. Because LARC requires a provider intervention to both initiate and discontinue the method, it is plausible that patient trust is associated with the choice to use LARC post-abortion.

Study design: This cross-sectional study explores the association between patient-level factors and choice of LARC post-abortion. Participants will be eligible if they are 18 or older, English-speaking, and undergoing surgical abortion at less than 14 weeks gestation. Each participant will complete a questionnaire on the day of their abortion. Choice of contraception post-abortion will be recorded. The primary predictive variable of interest is trust in the health care system. The primary outcome of interest is receipt of LARC post-abortion. Those receiving LARC will be compared to others using Chi-Square tests for categorical variables and t-tests or Wilcoxon rank sum tests for continuous variables. Logistic regression will be used for multivariate modeling.

Significance: The objective of this research is to understand the relationship between trust in the health care system and choice of LARC post-abortion. The findings from this work are expected to reveal novel information about how patient interactions within the health care system impact the decision to use LARC post-abortion. Knowledge gained from this research may improve counseling practices and inform interventions to increase use of LARC post

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