56 Assessing general paediatricians’ comfort level and clinical practice for counselling and prescribing contraception to adolescent patients in Southwestern Ontario
Bibliographic record
Abstract
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.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".