56 Assessing general paediatricians’ comfort level and clinical practice for counselling and prescribing contraception to adolescent patients in Southwestern Ontario
Notice bibliographique
Résumé
Abstract Background The Canadian Paediatric Society (CPS) recommends that all health care providers include contraception and fertility awareness in their management of adolescent patients, with long-acting reversible contraception (LARCs) recommended as first-line contraception for adolescents. There have been no Canadian studies identifying the contraception counselling and prescribing practices of Paediatricians or assessing their comfort with LARCs since the approval of implantable contraception options (etonorgestrel implant) by Health Canada in 2020. Objectives This anonymous survey was completed by general paediatricians and senior paediatric residents in Southwestern Ontario, Canada (a diverse, nationally representative population) to assess their comfort level with discussing and prescribing contraception options with adolescent patients. This knowledge will help to better target educational interventions in sexual and reproductive health for continuing medical education. Design/Methods Demographic data was collected for paediatricians including region of practice, years of practice, age and sex. Contraception practice characteristics included methods of discussing contraception, for which indications, and with what degree of perceived proficiency. Prescribing and counselling practices were compared between early practice (0-5 years of practice) and mid-late practice (>5 years of practice) groups, and community-based and tertiary care-based groups. Categorical variables were summarized using percentages, and comparisons between groups were examined using chi-square tests or Fisher's exact tests when applicable. Results Thirty-seven participants completed the survey, which represented 30.0% of the 123 physicians who were eligible to participate. Most respondents reported prescribing contraception regularly to adolescents (62.2%) or would refer adolescents to another provider to prescribe contraception if needed (24.3%). The majority of respondents (78.4%) would counsel their adolescent patients on contraception options. Notably, 37.8% of respondents did not counsel on an intrauterine device (IUD) and 67.6% did not counsel on the etonorgestrel implant. No respondent inserted IUDs or Nexplanon, and only 64.9% of respondents were aware of Nexplanon being available in Canada. Only 27.0% of respondents endorsed providing counselling for adolescent patients they see regularly. Conclusion While most respondents provided counselling and prescribed contraception to their adolescent patients, 1/3 of respondents were not comfortable with prescribing and 1/4 did not counsel regularly on contraception. Most participants did not follow guidelines of yearly counselling following sexual initiation as part of well-teen care (73.0%). There exists a need to better support paediatricians in gaining comfort in counselling and prescribing contraception to align with the current Canadian Paediatric practice recommendations.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».