{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T15:03:36Z","timestamp":1774019016405,"version":"3.50.1"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To analyze factors associated with the initiation of long-acting reversible contraception (LARC) among adolescent patients in inpatient settings in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This study is a secondary data analysis of the national Kids\u2019 Inpatient Database 2016 data (N = 4200 hospitals). Eligible patients were hospitalized girls 10 to 20 years old. The primary outcome was initiation of LARC (ie, subdermal implant and\/or intrauterine device [IUD]) while hospitalized. Covariables included age, race or ethnicity, insurance type, postpregnancy status, geographic region, hospital type (rural or urban), hospital size, and children\u2019s hospital status. Bivariable statistics were calculated by using survey-weighted analysis, and a design-based logistic regression model was used to determine the adjusted odds of LARC initiation and of implant versus IUD initiation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>LARC initiation occurred in 0.4% (n = 3706) of eligible hospital admissions (n = 874\u2009193). There were differences in LARC initiation by patient age, insurance type, race or ethnicity, postpregnancy status, hospital type, and hospital status (all P &amp;lt; .01). In the adjusted model, older age, public insurance, nonwhite race or ethnicity, postpregnancy status, and urban, teaching or larger hospitals were independently associated with LARC initiation (all P &amp;lt; .01). Smaller hospital size and postpregnancy status increased the odds of implant versus IUD initiation after stratifying by hospital region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>LARC initiation occurred in &amp;lt;1% of adolescent hospitalizations, with 90% of those occurring in postpregnancy adolescents. Addressing LARC capacity in rural, nonteaching, and smaller hospitals is important in increasing access. Future research is needed to identify and close gaps in the number of adolescents desiring and initiating LARC in hospital settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2020-001974","type":"journal-article","created":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T09:27:12Z","timestamp":1625131632000},"page":"764-770","source":"Crossref","is-referenced-by-count":5,"title":["Initiation of Long-Acting Reversible Contraception in Hospitalized Adolescents in the United States"],"prefix":"10.1542","volume":"11","author":[{"given":"Bianca A.","family":"Allison","sequence":"first","affiliation":[{"name":"Cecil G. Sheps Center for Health Services Research"},{"name":"Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Ritter","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Gillings School of Global Public Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kori B.","family":"Flower","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha F.","family":"Perry","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2021,7,1]]},"reference":[{"issue":"31","key":"2021121007502555700_b1","first-page":"1","article-title":"Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006-2010 national survey of family growth","author":"Martinez","year":"2011","journal-title":"Vital Health Stat 23"},{"issue":"3","key":"2021121007502555700_b2","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.jadohealth.2010.02.002","article-title":"Unintended pregnancy among U.S. adolescents: accounting for sexual activity","volume":"47","author":"Finer","year":"2010","journal-title":"J Adolesc Health"},{"issue":"13","key":"2021121007502555700_b3","first-page":"1","article-title":"Births: final data for 2018","volume":"68","author":"Martin","year":"2019","journal-title":"Natl Vital Stat Rep"},{"key":"2021121007502555700_b4","unstructured":"National Conference of State Legislatures. 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