{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T03:57:41Z","timestamp":1778039861204,"version":"3.51.4"},"reference-count":21,"publisher":"Guttmacher Institute","issue":"3","license":[{"start":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T00:00:00Z","timestamp":1394668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content> are infrequently used in the United States. Assessing how counseling about this method is delivered can help identify barriers to <jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content> use that might be overcome by improving services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sample of 342 family planning visits at six clinics in the San Francisco Bay Area in 2009\u20132012 were audio\u2010recorded, and patients completed surveys both before and after their visits. Descriptive quantitative analyses of counseling were performed, and correlates of <jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content>\u2019 being mentioned during counseling were investigated using logistic regression. Qualitative analyses investigated the counseling women received about <jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content> generally (in a subset of 42 visits), as well as counseling for women who already had an <jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content> in place (13 visits) or who felt their provider inappropriately expressed a preference for <jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content> (five visits).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content> were mentioned in 75% of visits. Patient\u2010initiated mention of <jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content> was more likely in visits by women aged 35 or older than in those by women younger than 20 (odds ratio, 6.4); provider\u2010initiated discussion of this method was less common if the provider was older than 55 than if he or she was younger than 46 (0.3). Providers more often discussed potential adverse effects of <jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content> use than benefits; counseling often was noninteractive and did not address how patient preferences related to characteristics of <jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content>. Counseling was frequently fragmented by the need for return visits or referral elsewhere for insertion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content> counseling may be improved by enhancing comprehensiveness and patient\u2010centeredness, and by decreasing fragmentation of care.<\/jats:p><\/jats:sec>","DOI":"10.1363\/46e0814","type":"journal-article","created":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T14:09:21Z","timestamp":1394719761000},"page":"133-140","source":"Crossref","is-referenced-by-count":28,"title":["Counseling About <scp>IUDs<\/scp>: A Mixed\u2010Methods Analysis"],"prefix":"10.1363","volume":"46","author":[{"given":"Christine","family":"Dehlendorf","sequence":"first","affiliation":[{"name":"Departments of Family and Community Medicine; Obstetrics, Gynecology and Reproductive Sciences; and Epidemiology and Biostatistics\u2014 University of California San Francisco 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