{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:21Z","timestamp":1787013861341,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Norwegian Government introduced in 2002 a reimbursement scheme for hormonal contraceptives to adolescents at the same time as public health nurses and midwives received authorization to prescribe hormonal contraceptives. This study examines the impact of increased accessibility and public funding on hormonal contraceptive use among adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>\n                      The Norwegian Prescription Database, Statistics Norway, and Norwegian Institute of Public Health served as data sources for this cohort study. The study population comprised 174\u2009653 Norwegian women born 1989\u20131990, 1994\u20131995, and 1999\u20132000. We examined use of hormonal contraceptives through dispensed prescriptions from age 12 through age 19 with duration of first continuous use as primary outcome. The statistical analyses were done in SPSS using chi\u2010squared test, survival analysis, and Joinpoint regression analysis with\n                      <jats:italic>p<\/jats:italic>\n                      \u2010values\u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>By age 19, ~75% of the cohorts had used at least one hormonal method. The main providers of the first prescription were general practitioners and public health nurses. Starters of progestogen\u2010only pills (POPs) have increased across the cohorts, while starters of combined oral contraceptives (COCs) have decreased. The use of long\u2010acting reversible contraceptives (LARCs) has increased since its inclusion in the reimbursement scheme (2015). Most switchers shifted from COCs or POPs as a start method to implants after LARCs became part of the reimbursement scheme. There has been a significant increase across the cohorts in the number of women who continuously used hormonal contraceptives from start to the end of the calendar year they became 19\u2009years with the same method and after switching methods. We could not correlate changes in decreasing trends for teenage births or induced abortions (Joinpoint analysis) to time for implementation or changes in the reimbursement of hormonal contraceptives from 2002.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Primarily public health nurses and to a lesser extent midwives became soon after they received authorization to prescribe COCs important providers. The expansion of the reimbursement scheme to cover POPs, patches, vaginal ring, and depot medroxyprogesterone acetate in 2006 had minor impact on increasing the proportion of long\u2010term first\u2010time users. However, the inclusion of LARCs in 2015 significantly increased the proportion of long\u2010term first\u2010time hormonal contraceptive users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14905","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T01:29:46Z","timestamp":1719538186000},"page":"1789-1798","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["How have changes in accessibility and public funding influenced contraceptive use among Norwegian adolescents? A cohort study"],"prefix":"10.1111","volume":"103","author":[{"given":"Sunniva","family":"S\u00e6b\u00f8","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Research Group Epidemiology of Chronic Diseases UiT the Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9875-4991","authenticated-orcid":false,"given":"Finn Egil","family":"Skjeldestad","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Research Group Epidemiology of Chronic Diseases UiT the Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Lov om svangerskapsavbrudd [abortloven] LOV\u20101975\u201006\u201013\u201050. [Termination of Pregnancy Act abortion act] In Norwegian.https:\/\/lovdata.no\/dokument\/NL\/lov\/1975\u201006\u201013\u201050"},{"key":"e_1_2_11_3_1","unstructured":"St. prp. nr. 122 (1977\u20131978). Oslo: Sosialdepartementet.1978.https:\/\/www.nb.no\/items\/7701fd534fe5f0eb1354441d9a7c38fc?page=403&searchText=om%20svangerskapsforebyggende%20tiltak%20og%20hjelpetiltak%20for%20vanskeligstilte%20gravide"},{"key":"e_1_2_11_4_1","unstructured":"F\u00f6rordning (1975:109). Reglemente (1955:592) f\u00f6r barnmorskor. Sveriges Riksdag.https:\/\/www.riksdagen.se\/sv\/dokument\u2010och\u2010lagar\/dokument\/svensk\u2010forfattningssamling\/reglemente\u20101955592\u2010for\u2010barnmorskor_sfs\u20101955\u2010592\/"},{"key":"e_1_2_11_5_1","unstructured":"Statens helsetilsyn Sosial\u2010 og helsedepartementet Barne\u2010 og familiedepartementet. Handlingsplan 1995\u201398 for forebygging av u\u00f8nskede svangerskap og abort. Oslo:1995 [Action plan 1995\u201398 for the prevention of unwanted pregnancies and abortions.] In Norwegian.https:\/\/www.nb.no\/items\/7ba39d9c8cad4abf0f363dd29d1ecc39?page=1&searchText=handlingsplan%20forebygging%20av%20u\u00f8nskede%20svangerskap"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0738-3991(94)90032-9"},{"key":"e_1_2_11_7_1","first-page":"2296","article-title":"Subsidized combined oral contraceptives to teenagers\u2014a 1\u2010year trial in G\u00e4vle","volume":"88","author":"Rahm VA","year":"1991","journal-title":"J Swedish Medical Ass"},{"key":"e_1_2_11_8_1","unstructured":"St. meld. nr. 16 (1995\u20131996). Oslo: Sosial\u2010 og helsedepartementet; 1995.https:\/\/www.nb.no\/items\/720ed40410206d46b9ee0e9148b05580?page=861&searchText=stortingsforhandlinger%201995%20svangerskap"},{"key":"e_1_2_11_9_1","unstructured":"SkjeldestadFE.Fors\u00f8k med samlivs\u2010 og prevensjonsveiledning i kommuner 1997\u20102000. Hovedrapport. Trondheim: SINTEF [A trial of sex and contraceptive counselling in communities (1997\u20132000)] In Norwegian.2001. Report No.: STF78 A012501."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625180701475558"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-1971(03)00031-9"},{"key":"e_1_2_11_12_1","unstructured":"Helsedepartementet. Rundskriv\u2014Retningslinjer for helses\u00f8stres og jordm\u00f8dres rett til \u00e5 rekvirere prevensjonsmidler til unge kvinner i alderen 16 til og med 19 \u00e5r. 2002. [Circular\u2014Guidelines for the right of health nurses and midwives to requisition contraceptives for young women aged 16 to 19\u2009years.] In Norwegian.https:\/\/www.helsedirektoratet.no\/rundskriv\/utvidet\u2010rekvireringsrett\u2010til\u2010helsesostre\u2010og\u2010jordmodre\u2010for\u2010prevensjonsmidler\/"},{"key":"e_1_2_11_13_1","unstructured":"Helse\u2010 og omsorgsdepartementet. Forebygging av u\u00f8nsket svangerskap og abort blant ten\u00e5ringer. Innf\u00f8ring av fast bidragssats for dekning av utgifter til hormonell prevensjon til unge kvinner i alderen 16 til og med 19 \u00e5r. 2006 [Prevention of unwanted pregnancy and abortion among teenagers. Introduction of a fixed contribution rate to cover the costs of hormonal contraception for young women aged 16 to 19\u2009years.].https:\/\/www.regjeringen.no\/globalassets\/upload\/kilde\/hod\/rus\/2006\/0004\/ddd\/pdfv\/274267\u2010rundskriv.pdf."},{"key":"e_1_2_11_14_1","unstructured":"Helsedirektoratet. Utvidet rekvireringsrett til helses\u00f8stre og jordm\u00f8dre for prevensjonsmidler \u2013 Helses\u00f8stre og jordm\u00f8dres administrering av Langtidsvirkende reversibel prevensjon (LARC). Rundskriv IS\u201013\/2015: Helsedirektoratet; [Extended right of requisition to health nurses and midwives for contraceptives \u2010 Health nurses and midwives' administration of Long\u2010acting reversible contraception (LARC).] In Norwegian. 2015.https:\/\/www.helsedirektoratet.no\/rundskriv\/utvidet\u2010rekvireringsrett\u2010til\u2010helsesostre\u2010og\u2010jordmodre\u2010for\u2010prevensjonsmidler\/"},{"key":"e_1_2_11_15_1","unstructured":"Helfo. St\u00f8nad til prevensjon for unge kvinner. T\u00f8nsberg: 2019 (updated 28.01.2021). [Benefit for contraception for young women.] In Norwegian.https:\/\/www.helfo.no\/regelverk\u2010og\u2010takster\/stonad\u2010til\u2010prevensjon\u2010for\u2010unge\u2010kvinner\/stonad\u2010til\u2010prevensjon\u2010for\u2010unge\u2010kvinner"},{"key":"e_1_2_11_16_1","unstructured":"Norwegian Institute of Public Health.http:\/\/www.fhi.no"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"e_1_2_11_18_1","unstructured":"Joinpoint Regression Program Version 5.0.2.Statistical Methodology and Applications Branch Surveillance Research Program National Cancer Institute US.2023."},{"key":"e_1_2_11_19_1","article-title":"Adolescent girls in Denmark use oral contraceptives at an increasingly young age, and with more pauses and shifts","volume":"61","author":"L\u00f8kkegaard E","year":"2014","journal-title":"Dan Med J"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.07.105"},{"key":"e_1_2_11_21_1","unstructured":"Statens legemiddelverk. Referat fra m\u00f8te i bivirkningsnemnda 28.januar 2009. [Minutes from a meeting of the side effects committee on 28 January 2009.] In Norwegian.http:\/\/docplayer.me\/amp\/15563885\u2010Referat\u2010fra\u2010mote\u2010i\u2010bivirkningsnemnda\u201028\u2010januar\u20102009.html"},{"key":"e_1_2_11_22_1","unstructured":"Informasjon til helsepersonell (Brev).Kombinerte hormonelle prevensjonsmidler: V\u00e6r oppmerksom p\u00e5 for skjeller mellom preparatene n\u00e5r det gjelder risiko for blodpropp og betydningen av individuelle risikofaktorer. 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[Recommended hormonal contraceptives.].2016.https:\/\/legemiddelverket.no\/bivirkninger\u2010og\u2010sikkerhet\/rad\u2010til\u2010helsepersonell\/p\u2010piller\/anbefalte\u2010hormonelle\u2010prevensjonsmidler"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0305701"},{"key":"e_1_2_11_27_1","unstructured":"National Statistics.Abortion statistics England and Wales 2021. Office for Health Improvement & Disparities Gov.https:\/\/www.gov.uk\/government\/statistics\/abortion\u2010statistics\u2010for\u2010england\u2010and\u2010wales\u20102021\/abortion\u2010statistics\u2010england\u2010and\u2010wales\u201020212023."},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss7110a1"},{"key":"e_1_2_11_29_1","volume-title":"Abortion Services Aotearoa New Zealand: Annual Report","author":"Ministry of Health","year":"2021"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022473"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-523"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2015.03.016"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T06:45:23Z","timestamp":1743921923000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,27]]},"references-count":31,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/aogs.14905"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14905","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,27]]},"assertion":[{"value":"2023-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}