{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T13:52:14Z","timestamp":1794491534192,"version":"4.9.1"},"reference-count":69,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Symptoms of mental distress increased sharply during the COVID-19 pandemic, especially among older adolescents and young adults. Mental health distress may make it more challenging for young people to seek other needed health care, including contraception. This study explored the association of symptoms of depression, anxiety, and stress with delays in getting a contraceptive method or prescription.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Data from a supplementary study (May 15, 2020\u2013March 20, 2023) to a cluster randomized trial in 29 sites in Texas and California were used. The diverse study sample included community college students assigned female at birth of ages 18\u201329 years (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1,665 with 7,023 observations over time). We measured the association of depression (CES-D [Center for Epidemiologic Studies Depression Scale]) or anxiety and stress (DASS-21 [Depression Anxiety Stress Scales]) symptoms with delayed contraceptive care-seeking with mixed-effects multivariable regression with random effects for individual and site. We controlled for age and sociodemographic factors important for access to care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Over one-third of participants (35%) reported they delayed getting the contraceptive method they needed. Multivariable regression results showed increased odds of delayed contraceptive care among participants with symptoms of depression (adjusted odds ratio [aOR] 1.58, 95% confidence interval [CI] 1.27\u20131.96). Likewise, delays were associated with anxiety and stress symptoms (aOR 1.46, 95% CI 1.17\u20131.82). Adolescents were more likely to delay seeking contraception than young adults (aOR 1.32, 95% CI 1.07\u20131.63).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Results showed a strong association between mental distress and delayed contraception. Interventions are needed to increase contraceptive access for young people delaying care, along with supportive mental health care services, including for adolescents who face elevated odds of delay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>ClinicalTrials.gov Identifier:<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT03519685\">NCT03519685<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2023.0549","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T05:30:12Z","timestamp":1710135012000},"page":"870-878","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5587-6398","authenticated-orcid":false,"given":"Cynthia C.","family":"Harper","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology &amp; Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Yarger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology &amp; Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Mangurian","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Sciences, Weill Institute for Neurosciences, School of Medicine, University of California, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Population Research Center, University of Texas at Austin, Austin, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5479-5422","authenticated-orcid":false,"given":"Irene","family":"Rossetto","sequence":"additional","affiliation":[{"name":"Population Research Center, University of Texas at Austin, Austin, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Elmes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology &amp; Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah K.","family":"Hecht","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology &amp; Reproductive Sciences, Bixby Center for Global Reproductive Health, School of Medicine, University of California, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Population Research Center, University of Texas at Austin, Austin, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Del Mar Community College, Corpus Christi, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitra","family":"Shokat","sequence":"additional","affiliation":[{"name":"School of Medicine, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia R.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"American Psychological Association. 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