1. Improving Contraceptive Care Assessing and Promoting “Bedsider” in Women’s Health Practice Preliminary Findings From Baseline Presenter: Janine M. Talis Faculty Advisor: Samar R. El Khoudary, PhD, MPH Internship Advisor: Elizabeth Miller, MD, PhD, Adolescent and Young Adult Medicine at Children’s Hospital of Pittsburgh of UPMC

2. Why is contraception important? Contraception is the only means of protecting oneself against pregnancy in sexually active people Condoms specifically protect against pregnancy AND STDs 7 in 10 pregnancies among 18-29 year old, unmarried women are unplanned There is a pervasive culture of contraception misinformation which leads to higher rates of unintended pregnancies Many women are not informed about all of their contraceptive options

3. What is Bedsider? Bedsider.org is an online birth control tool Operated by the National Campaign to Prevent Teen and Unplanned Pregnancy Aimed at 18-29 year olds Objective of the site is to help women more effeciently choose a form of birth control, and use it effectively and consistently.

4. Besider.org Method Explorer

5. Study Objectives Introduce women going to the University of Pittsburgh Student Health Center to the Bedsider tool Determine if it is a useful aid in choosing contraception Determine if implementation of the Bedsider tool can be use as a time-saving measure for providers

6. Study Objectives: Preliminary Findings from Baseline Determine popularity of different contraception methods among female students at the Student Health Center Compare what is being used to the “real- life” effectiveness of available contraceptions. Based on CDC’s “Effectivenss of Family Planning.” 1 1 Number of unintended pregnancies for each method out of every 100 women

7. Methods Baseline Enrolled 50 total female participants using Student Health Services aged 18-29. Participants were approached about during visit with participating providers. Stopped once reached 50. Participants took one 5-10 minute survey at time of appointment. Future Follow-Up Participants will be sent a 20-30 minute survey 2-4 weeks after enrollment Providers will take a 20-30 minute survey 2-6 weeks after enrollment begins Chart extraction to determine if change of method occurred after introduction to Bedsider

8. Methods Survey 1: Assess participants sexual activity, contraceptive method of choice, partner safety, and if they were introduced/receptive to the Bedsider tool Survey 2: Assess likeability/ease of use of Bedsider tool, and how it compares to a face-to-face visit Provider Survey: Assess likelihood of providers in the bringing up of safe relationships and contraceptive options within clinic visits, and likeability of Bedsider tool Inclusion Criter1aExclusion Criteria Female (including Female-to-Male transgender)Pregnancy Seeking care at Pitt Main Student Health Services Aged 18-29 Seeking contraception, contraception change, or considering a method change

9. Racial/Ethnic Distribution of Study Participants Race/Ethnicity% (n) 1 White90% (45) Black/African-American4% (2) Asian4% (2) Multiracial/Other4% (2) Hispanic/Latino?% (n) No84% (42) Yes16% (4) 1 Percentages may not sum to 100% as women could endorse more than one method

10. Age/Sexual Preference Distribution of Study Participants Age% (n) 18-2052% (26) 21-2442% (21) 25+6% (3) Sexual Attraction% (n) Men90% (45) Women2% (1) Both8% (4) Gender of Partners% (n) Men Only91.5% (43) Mostly Men6.4% (3) Equally Men and Women2.1% (1) 100% of participants are biologically, and identify as female

11. Results: Contraceptive Use MethodEver Used 1 Used Last 3 months 1 Never had sex/No sex in 3mo6% (3)8% (4) Don’t use anything0% (0) Pull out/Withdrawal58% (29)38% (19) Condoms94% (47)66% (33) Birth Control Pills74% (37)54% (27) Depo-Provera (injectable)2% (1) Patch (Ortho Evra)0% (0) Vaginal Ring (NuvaRing)8% (4) IUD (Mirena/ParaGard)0% (0) Implant (Nexplanon)0% (0) Morning After Pill (Plan B)34% (17)10% (5) Other0% (0) 1 Percentages may not sum to 100% as women could endorse more than one method

12. Level of Effectiveness 1 Contraceptive Methods Ever Used by Study Participants(%(n)) 2 Highly Effective2% (3) Moderately Effective30% (42) Poorly Effective68% (93) No Method/Other0% (0) 1 Bedsider.org 2 Percentages based on total methods used, not total women

13. Conclusions Of the women who are sexually active, all have said that they have used condoms But only 2/3 used them in the last 3 months Condoms are the only method that prevents STDs in sexually active people Birth control pills are the most popular method Only considered a moderately effective method, mainly due to inconsistent use

14. Conclusions No women used Long-Acting, Reversible Contraception (LARCs) which are considered the most highly effective birth control method LARCs significantly harder to tamper with Most effective contraception for sexually active women Less prone to misuse Women need to be better informed about their contraceptive options and the effectiveness of those options

15. Limitations Small sample size (n=50) Only conducted at one site (Student Health Center) Lack of diversity within population Results not generalizable Do not know level of adherence women have to their chosen method Always use, sometimes use, rarely use?

16. Evaluation of Internship I learned the value of qualitative skills alongside quantitative skills Developed a greater sense of the value of research and the amount of effort put into each project, after being allowed to participate in a number of studies in the department I was able to work with a number of highly skilled, intelligent, and overall wonderful people Gained a new sense of direction toward my future and the subjects I’d like to continue learning about

17. Acknowledgements Dr. Elizabeth Miller, MD, PhD for accepting me into her department Dr. Samar R. El Khoudary for all of her academic help and guidance Yukiko Giho, NP for being patient PI on the study Dr. Nancy Glynn for finding me this internship as well as for the significant amount of other help she’s provided me with over the last 2+ years All of the staff in the Adolescent and Young Adult Medicine Department at Children’s for their kindness, patience, and wonderful sense of community