Qualitative Study: The Diffusion Innovation Theory to Long Term Reversible Contraception Method Selection in High Risk Women, Malang District

Research objective: Long-term reversible contraceptive method (LTRC) is the most effective form of contraception but women prefer lesser effective method. In this study we explored whether women of reproductive age will accept or reject LTRC as their contraceptive innovation, and how their perceptions on the innovation's attributes influence their decision in choosing LTRC.Design, participants, interventions, and outcomes: The research design used was a qualitative descriptive study with high-risk reproductive women who were over 35 years old (16 people) spread over 4 health centers (puskesmas) as participants. Data collection was done by using focus group discussion. The results were analyzed using thematic content analysis.Result: Data analysis revealed that there were 2 subgroups of participants based on their tendency to use LTRC: positive (n 6) and negative (n 10). Most of the participants were aware of the advantages of long-term reversible contraceptive methods. They get information from health workers, the media and other people's experiences. They think that both IUD and implants have a high complexity / difficulty, especially the IUD. The characteristics of innovation in the form of relative advantage, compatibility, complexity, trialability and ease of observation greatly influence the decision to choose a long-term reversible contraceptive method. Most of the participants refused to try using the LTRC because it was too risky to try and too complicated to use.Conclusion: Most women are still hesitant to choose LTRC as a contraceptive, especially intrauterine contraceptives. They need more information about the advantages of LTRC

Download Full-text

Pengaruh Keinginan Pasangan Usia Subur (Pus) dalam Penggunaan Metode Kontrasepsi Jangka Panjang

Jurnal Biometrika dan Kependudukan ◽

10.20473/jbk.v5i1.2016.27-34 ◽

2017 ◽

Vol 5 (1) ◽

pp. 27

Author(s):

Sumartini Sumartini ◽

Diah Indriani

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Family Support ◽

Contraceptive Method ◽

Health Workers ◽

Sampling Technique ◽

Reproductive Age ◽

Short Term ◽

The Family

One of the most eff ective eff ort in the family planning program was to control fertilitas and press the population growth rate was used contraception. In the area of Puskesmas Pacar Keling Surabaya interest of acceptor which used short term contraceptive method still high than long term contraceptive method. This research used analytical observational study with case control methods. The population is all woman reproductive age couples aged 15-49 years old in the area of Puskesmas Pacar Keling Surabaya. Sampling technique used two stage random sampling and got 90 respondent. The variables were age, knowledge, side eff ects, desire to have a child again, husband and family support. Data were analyzed with multiple logistic regression with al level of signifi cance value α= 0,05. The result of logistic regression analysis signifi cant variables were age (p= 0,002), side eff ects (p= 0,005), desire to have a child again (p= 0,028), husband and family support (p= 0,008). Conclusion of research is that age, side effects, desire to have more children, husband and family support infl uencing reproductive age couples using long term contraceptive methods. This research suggest health workers provide Counselling and information about Family Planning to reproductive age couples specially they were 20-30 years old about explanation of the use of long term contraception method.

Download Full-text

PEMILIHAN KONTRASEPSI BERDASARKAN EFEK SAMPING PADA DUA KELOMPOK USIA REPRODUKSI

Unnes Journal of Public Health ◽

10.15294/ujph.v6i3.11543 ◽

2017 ◽

Vol 6 (3) ◽

pp. 167

Author(s):

Erna Setiawati ◽

Oktia Woro Kasmini Handayani ◽

Asih Kuswardinah

Keyword(s):

Side Effects ◽

High Risk ◽

Random Sampling ◽

High Risk Pregnancy ◽

Reproductive Age ◽

Cross Sectional ◽

Whitney Test ◽

Mann Whitney Test ◽

Risk Pregnancy

ABSTRACT Kelompok usia reproduksi terbagi dalam tiga fase yaitufase menunda kehamilan (<20 tahun), fase menjarangkan kehamilan (20-30 tahun) dan fase mengakhiri kehamilan (>30 tahun). Cara yang ditempuh yaitu dengan pemakaian kontrasepsi.baik MKJPmaupunnon MKJP. Tujuan penelitian ini adalah untuk mengetahui ada atau tidak perbedaan pemilihan kontrasepsi MKJP dan non MKJP berdasarkan efek samping pada dua kelompok usia reproduksi. Penelitin ini menggunakan desain cross sectional, pengambilan data dengan kuesioner. Sampel dalam penelitian ini adalah akseptor KB baik MKJP maupun non MKJP pada bulan april sampai juni sebanyak 200 responden, dimana tekhnik pengambilan datanya dengan random sampling dan kuota sampling. Hasil penelitian kemudian diuji dengan mann-whitney test.Hasil penelitian dengan uji mann whitney test diperoleh p = 0.662 dengan kata lain p > α (0.05) yang berarti tidak ada perbedaan pemilihan MKJP dan non MKJP berdasarkan efek samping di Wilayah Kabupaten Semarang. ABSTRACT Reproductive-age category can be divided into three groups which are the group of delayed interval pregnancy (less than 20 years old), the group of intervalcontrol pregnancy (20 to 30 years old), and the group of high risk pregnancy (more than 30 years old). An alternative to avoid high risk pregnancy is by using contraception tool namely long-term contraception (MKJP) and non long-term contraception (non MKJP).The purpose of this research is to analysedwhether there are differences in choosing MKJP and non –MKJP based on side effects in the two reproductive-age groups.This research was an explanatory research with cross-sectional design. The population were all women of contraception acceptors in Semarang Regency.The samples were 200 respondents, used simple random sampling and quota sampling. This research used quisionaire instrument and analyze used mann whitney test (α=0,05). Theresult showed thatP = 0,662 meaning P > α = 0.05 which means there is no difference in choosing MKJP and non-MKJP based on side effects in the two reproduction-age groups in Semarang regency.

Download Full-text

P5730Do hypertensive women with coronary artery disease benefit from lowering systolic blood pressure under 130 mmHg? Long-term mortality in the INternational VErapamil SR-trandolapril STudy (INVEST)

European Heart Journal ◽

10.1093/eurheartj/ehz746.0670 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

R I Sava ◽

Y Chen ◽

Y K Taha ◽

Y Gong ◽

S M Smith ◽

...

Keyword(s):

Myocardial Infarction ◽

Blood Pressure ◽

Coronary Artery Disease ◽

High Risk ◽

Risk Group ◽

Low Risk ◽

High Risk Women ◽

Artery Disease ◽

Long Term Mortality

Abstract Background Hypertension (HTN) and coronary artery disease (CAD) are a prevalent combination in women, however limited data are available to guide blood pressure (BP) management. We hypothesize older women with HTN and CAD may not derive the same prognostic benefit from systolic BP (SBP) lowering <130 mmHg. Purpose To investigate the long-term mortality implications of different achieved SBP levels in hypertensive women with CAD. Methods Long-term, all-cause mortality data were analyzed for 9216 women, stratified by risk attributable to clinical severity of CAD (women with prior myocardial infarction or revascularization considered at high, all others at low risk) and by age (50 - <65 or ≥65 yo). The prognostic impact of achieving mean in-trial SBP <130 (referent group) was compared with 130 to <140 and ≥140 mmHg using Cox proportional hazards, adjusting for demographic and clinical characteristics. Results During 108,838 person-years of follow-up, 2945 deaths occurred. High risk women (n=3011) had increased long-term mortality in comparison to low risk women (n=6205) (adjusted HR 1.38, CI 1.28–1.5, p<0.001). Within risk groups, crude mortality percentages decreased according to BP values (table). As expected, high risk women were more likely to be ≥65 yo (68.68% vs. 50.51%, p<0.0001) or have SBP ≥140 mmHg (43.08% vs. 31.18%, p<0.0001). In adjusted analyses, an SBP ≥140 mmHg was associated with worse outcomes than SBP <130 mmHg in the entire cohort (HR 1.3, CI 1.2–1.5, p<0.0001) and when stratifying by risk (low risk group, HR = 1.47, CI 1.28–1.7, p<0.0001; high risk group, HR = 1.71, CI 1.01–1.35, p=0.03). In analyses stratified by age and risk, women ≥65 years and at high risk had decreased mortality in the 130 - <140 SBP category vs. <130 mmHg (HR 0.812, 95% CI 0.689–0.957, p=0.0133; figure). Women and deaths by risk and SBP group Group SBP category Women (n) Mortality (n) Mortality (%) High risk <130 773 338 44 130–<140 941 414 44 ≥140 1297 694 54 Low risk <130 2187 390 18 130–<140 2083 451 22 ≥140 1935 658 34 SBP = systolic blood pressure; n = number; % = percent per each group. Mortality adjusted HRs Conclusion In women ≥65 yo with hypertension and prior myocardial infarction and/or coronary revascularization enrolled in INVEST, a SBP between 130 to <140 mmHg was associated with lower all-cause, long-term mortality versus SBP <130 mmHg. Acknowledgement/Funding The main INVEST (International Verapamil [SR]/Trandolapril Study) was funded by grants from BASF Pharma, Ludwigshafen, Germany; Abbott Laboratories, A

Download Full-text

Determinants of modern contraceptive preference among mothers (15-49 years) in central zone, Tigray region, Ethiopia; qualitative study finding

International Journal of Medicine ◽

10.14419/ijm.v5i2.7791 ◽

2017 ◽

Vol 5 (2) ◽

pp. 172

Author(s):

Merhawi Gebremedhin ◽

Ayele Belachew ◽

Demeke Desta

Keyword(s):

Family Planning ◽

Qualitative Study ◽

English Language ◽

Health Workers ◽

Group Discussion ◽

Central Zone ◽

Study Finding ◽

Reproductive Age ◽

Modern Contraceptive ◽

Cross Sectional

Contraceptive method choice is a fundamental indicator of quality of care in a family planning program. Contraceptive choice is one component of quality in family planning and offering minimum of three modern methods of contraceptives is a critical indicator. One-third of developing countries have many skewed method mixes, which is a risky for discontinuation, contraceptive dissatisfaction and unintended pregnancy. In Ethiopia, the prevalence of contraceptive is highly skewed, 76% for injectable. Therefore, the purpose of qualitative study was to assess determinants of modern contraceptive preference among reproductive age (15-49 years) in Central Zone of Tigray.Methodology: the study was conducted in the central zone of Tigray and community, and facility based qualitative cross-sectional study was applied. Six focus group discussion entails of reproductive age mothers and 15 In-depth Interview with health workers constitutes the sample. Data was first transcribed and then translated into English language. Open code software was applied to analyze data and data was coded segment by segment then categorized using thematic analysis to give meaning.Result: community’s awareness and acceptance to use modern contraceptives have improved from time to time. Contraceptive preference is determined by community acceptance, health care system problem, individual context and socio-cultural problem. For majority of respondents, preference to long acting contraceptive is mainly influenced by husband.Conclusion: currently, women are preferring short-acting contraceptive preferably injectable than long acting.Implanon is preferred next to injectable. A strong information, education and communication that address all portions of the population and able to change the community’s attitude should do at the grass root level.

Download Full-text

Single Agent Arsenic Trioxide in the Treatment of Newly Diagnosed Acute Promyelocytic Leukemia: Long Term Follow-up Data.

Blood ◽

10.1182/blood.v114.22.846.846 ◽

2009 ◽

Vol 114 (22) ◽

pp. 846-846

Author(s):

Vikram Mathews ◽

Biju George ◽

Kavitha M Lakshmi ◽

Auro Viswabandya ◽

Ezhilarasi Chendamarai ◽

...

Keyword(s):

High Risk ◽

Risk Group ◽

Single Agent ◽

High Risk Group ◽

Reproductive Age ◽

Newly Diagnosed ◽

Long Term Follow Up ◽

Good Risk

Abstract Abstract 846 We had previously reported a well tolerated regimen using single agent arsenic trioxide (ATO) (Blood 2006:107; 2627) leading to durable remissions in patients with newly diagnosed acute promyelocytic leukemia (APL). Briefly, the regimen consisted of ATO (10mg/day for adults and 0.15mg/kg/day for pediatric patients) for up to 60 days in induction; this was followed by a 28 day consolidation after a 4 week break. Four weeks after completion of consolidation, patients received ATO for 10 days/month for 6 months. A concern with the previous report was the relatively short duration of follow up. Here we report the long term follow-up data of the same cohort. As previously reported, 72 newly diagnosed cases of APL were enrolled. 62 patients (86.1%) achieved hematological remission. The remaining died prior to achieving remission. There were no primary induction failures. Twenty two (30.6%) of these patients were considered good risk group (WBC count at diagnosis <5×109/L and a platelet count >20×109/L), the rest were considered high risk. Since publication of the last report an additional 7 patients have relapsed to give a total of 13 relapses, 2 were in the good risk group and the remaining 11 in the high risk group. The relapses in the good risk group were salvaged with an autologous SCT and have durable continued second remissions. The median time to relapse was 1.5 years. Five (38.52%) of these relapses occurred beyond 2 years and included both relapses in the good risk group. At a median follow-up of 58 months the 5-year Kaplan-Meier overall survival (OS), event free survival (EFS) and disease free survival (DFS) of the entire cohort was 74.22±5.26%, 68.93±5.52% and 80.00±5.17% respectively. The 5-year OS and EFS of the good risk and high risk group was 100±00% vs. 63.30±6.9% and 90.00±6.71% vs. 59.66±6.99% respectively. Beyond induction, all deaths followed relapse of disease. There were no second malignancies reported. Besides the previously reported toxicities, which were mild and transient in most cases, there were no new toxicities that were reported on continued follow up of these cases. Since completion of therapy, in spite of counseling and advising against pregnancy, 3 males and 4 females in the reproductive age group have had 8 normal children. No abortions, still births or fetal defects were reported among patients in the reproductive age group in this cohort. Hair and nail samples from 5 cases that had completed maintenance therapy more than 24 months earlier have been collected for analysis, the results of which are awaited. At our center the cost of administering this regimen is a quarter of that of a conventional ATRA plus anthracycline based regimen. Additionally, after the initial induction therapy the rest of the treatment did not require hospital admission nor did it result in any Grade III/IV hematological toxicity. Single agent ATO based regimen as reported previously is well tolerated, results in durable remissions and does not have any significant late side effects. In the good risk group it is associated with excellent clinical outcomes while in the high risk group additional interventions are probably required to reduce the risk of late relapses. In a resource constrained environment it is probably the best option. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

A survey study of the impact of COVID-19 on women at high risk for infant mortality in Central Indiana

Proceedings of IMPRS ◽

10.18060/25853 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Tanvi Asthana ◽

Qing Tang ◽

Matt Hodges ◽

Debra Litzelman

Keyword(s):

High Risk ◽

Infant Mortality ◽

Food Insecurity ◽

Community Health ◽

Health Workers ◽

Survey Study ◽

Chi Square ◽

Daily Lives ◽

High Risk Women ◽

The Impact

Background/Objective: The WeCare program aims to reduce infant mortality through the community health worker model by assisting high risk women of child-bearing age. The COVID-19 pandemic introduced additional challenges for women already at high risk factor for infant mortality (IM). The aim of this survey study is to assess the impact of the COVID-19 pandemic in this population. Methods: Enrolled WeCare participants were given an optional COVID-19 phone survey (modified from the IeDEA survey*) between August 2020 and May 2021 to assess the impact of COVID-19 on their daily lives, income, food security, and mental health. Trained research assistants and community health workers administered surveys. Verbal consent was obtained over the phone. Data was entered into REDCap. From REDCap, data was exported to SAS version 9.4 to calculate descriptive statistics and chi square tests. Results: Fifty-six primarily women of color (68%) completed the survey. Sixty-two percent of women lived in high-risk zip codes for infant mortality in Central Indiana. Fifty-seven percent of women worked prior to the outbreak. Forty-eight percent of the working women lost income, and seventy percent of women worked jobs requiring interaction with the public. These women experienced greater food insecurity (38%), depression (24%), and anxiety (31%) compared to before the pandemic (p<0.001). Conclusion/Discussion: The demographics and residence of those interviewed were representative of the WeCare cohort (NS differences in race/ethnicity/age). In comparing the prevalence of food insecurity, depression and anxiety between the survey sampled during covid and prior to covid, all factors were significantly increased. These vulnerable women (many pregnant or postpartum), often major breadwinners in their household, held jobs putting them at high risk for covid infections, and lost these high-risk jobs at an alarming rate. These data confirm the detrimental impact of COVID-19, especially on a population already at high risk for IM. Acknowledgement of original authors of the *IeDEA survey: Suzanne Goodrich, Michael Scanlon, Leslie Enane, Kara Wools-Kaloustian

Download Full-text

Long-Term, Reversible Contraception Use Among High-Risk Women Treated in a University-Based Gynecology Clinic: Comparison Between IUD and Depo-Provera

Journal of Women s Health ◽

10.1089/jwh.2009.1518 ◽

2010 ◽

Vol 19 (2) ◽

pp. 349-353 ◽

Cited By ~ 6

Author(s):

Karen L. Cropsey ◽

Catherine Matthews ◽

Samuel Campbel ◽

Sara Ivey ◽

Swati Adawadkar

Keyword(s):

High Risk ◽

High Risk Women ◽

Contraception Use ◽

Depo Provera

Download Full-text

Quality of Care in Family Planning Services: Differences Between Formal and Informal Settlements of Kira Municipality, Uganda

Frontiers in Global Women's Health ◽

10.3389/fgwh.2021.656616 ◽

2021 ◽

Vol 2 ◽

Author(s):

Zubair Lukyamuzi ◽

Moses Tetui ◽

Osvaldo Fonseca-Rodríguez ◽

Lynn Atuyambe ◽

Fredrick Edward Makumbi ◽

...

Keyword(s):

Quality Of Care ◽

Family Planning ◽

Health Workers ◽

Informal Settlements ◽

Reproductive Age ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Process Factors

Background: Quality of care (QoC) of family planning (FP) affects contraceptive use, and it varies across types of urban settlement. This study assesses the difference in service delivery point (SDP) structural and process factors between formal and informal urban settlements, and the opinion of the client on the QoC in informal settlements. This is useful in creating an evidence base to advocate for better quality services for the most vulnerable in society.Methods: This was a cross-sectional survey that included SDPs of Kira municipality in Wakiso district, Uganda. Data were collected from all the service points in Kira municipality with the caretakers consented. In addition, using multi-stage sampling, 626 women of reproductive age (15–49 years) who lived in the informal settlements of Kira municipality were interviewed. Data were collected using structured questionnaires, descriptive analysis was carried out in Stata version 14.0, and Chi-square and t-tests were used to compare the informal with the formal settlements.Results: Formal settlements generally had more higher-level SDPs compared to informal settlements (value of p < 0.001). SDPs in the formal settlements provided more FP methods and had more community health workers (CHW) to support their work. Also, SDPs in the formal settlements were more likely to have long-term FP methods available and more likely to have trained personnel to insert and remove implants and IUDs compared to those in informal settlements. Additionally, more SDPs in the formal settlements provided counseling for permanent, long-term, and short-term FP methods. Of the 626 interviewed women, most of the women (68.6%) reported that they would not return to the previous FP provider or refer a friend to the same provider (72.7%).Conclusions: There is a lower quality FP services in the informal settlements with a commensurable effect on the client satisfaction with the services. Therefore, improving the quality of FP services in informal settlements should be a top priority. Improved quality of services could act as a motivation to increase the uptake of modern contraceptives in such settings.

Download Full-text