Exploring Women’s Experiences with Deciding to Use and Access Long-Acting Reversible Contraception
Bibliographic record
Abstract
Women spend nearly half their life able to become pregnant. Despite the growing number of contraceptive options available, women continue to select user-dependent options over the user-independent long-acting reversible contraception (LARC). This in part contributes to the current rate of unintended pregnancy and abortion. Increasing LARC use has been proposed as one way to reduce unintended pregnancies and calls have been made for increasing women’s access to LARC. The purpose of this thesis was to explore women’s experiences with deciding to use a LARC and accessing the method. This was explored through two research projects. The first project was a scoping review of the literature. This was completed to identify healthcare professional led LARC services with an evaluation of the services. A systematic search of four electronic databases was completed with 40 articles meeting the inclusion criteria. The identified services included counselling about LARC and providing LARC methods. These services were offered by a range of healthcare provider disciplines including physicians, nurses, pharmacists, and midwives. The services frequently increased LARC uptake by women and clients were satisfied with the services they received. This review suggests there are several service models that can have an impact on LARC use. However, it was noted that the perspectives of potential LARC users were not considered when designing the services, nor were women’s opinions on the services always evaluated. The second project in this thesis was a qualitative study that explored the lived experiences of women who have decided to use a LARC method and have accessed the method in Alberta, Canada. Qualitative Description and Community Based Participatory Research frameworks were followed. Participants were purposefully recruited from the Birth Control Centre, an Edmonton-based clinic. One-on-one virtual interviews were conducted, and the data were analyzed through Reflexive Thematic Analysis. Four themes were generated from the analysis: 1) Actively Seeking Information, 2) Weighing Perceived Benefits and Drawbacks of LARC, 3) Deciding for Yourself, and 4) The Variable Experience of Access. Themes 1 to 3 provide insight into women’s active role in the decision-making process. The fourth theme encompasses the five factors women described to affect their ability to access LARC: the availability and awareness of services, patient-healthcare provider connections, appointment availability and wait times, device availability, and LARC cost and coverage. This study highlights the active role women take when considering LARC methods and their desire to make decisions about LARC themselves. This study also identified accessing LARC as a highly individual experience. The findings from this thesis identified several factors that women perceived to affect access to LARC methods. Additionally, this thesis provides new insights into how women decide to use LARC methods. Further research is required to understand the experiences of women living in rural settings and the experiences of gender diverse individuals. This thesis highlights the opportunities for healthcare providers to engage with women considering LARC and improve women’s ability to access LARC.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.034 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.005 | 0.007 |
| Scholarly communication | 0.006 | 0.007 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".