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Pediatric Hematology Providers’ Contraceptive Practices for Female Adolescents and Young Adults with Sickle Cell Disease: A national survey
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  • Megan Askew,
  • Arlene Smaldone,
  • Melanie Gold,
  • Kim Smith-Whitley,
  • John Strouse,
  • Jin Zhezhen,
  • Nancy Green
Megan Askew
NewYork-Presbyterian/Columbia University Medical Center

Corresponding Author:[email protected]

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Arlene Smaldone
Columbia University Irving Medical Center
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Melanie Gold
NewYork-Presbyterian/Columbia University Medical Center
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Kim Smith-Whitley
The Children's Hospital of Philadelphia
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John Strouse
Duke University School of Medicine
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Jin Zhezhen
Columbia University Mailman School of Public Health
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Nancy Green
Columbia University
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Background Adolescent and young adult (AYA) women with sickle cell disease (SCD) have increased pregnancy-related health risks and are prescribed potentially teratogenic medications, yet little is known about pediatric SCD provider contraceptive practices. We aimed to assess pediatric hematology providers’ beliefs, practices, motivators, and barriers for providing contraceptive care to female AYA with SCD. Methods Guided by the Health Belief Model (HBM), we developed a 25-question, web-based survey to assess providers’ practices. Survey links were distributed nation-wide to pediatric SCD and/or general hematology providers through their publicly available emails and by request to directors of U.S. accredited Pediatric Hematology-Oncology fellowship programs for distribution to their SCD providers. Data analysis included descriptive statistics, chi-square analysis, logistic regression. Results Of 177 respondents, 160 surveys meeting inclusion criteria were analyzed. Most providers reported counseling (77.5%) and referring female AYA patients for contraception (90.8%), but fewer reported prescribing contraception (41.8%). Counseling practices significantly differed in trainees versus established providers (54% vs. 85%, p<0.001) with a similar trend for prescribing (p=0.05). Prescription practices did not differ significantly by provider beliefs regarding potential teratogenicity of hydroxyurea. Key motivators included patient request and disclosure of sexual activity. Key barriers included inadequate provider training, limited visit time, and perceived patient/parent interest. Conclusion Provider contraceptive practices for female AYA with SCD varied, especially by provider status. Health beliefs regarding teratogenic potential of hydroxyurea did not correlate with contraceptive practices. Clinical guidelines, provider training, and patient/parent decision-making tools may be tested to assess whether provider contraceptive practices could be improved.
24 Feb 2022Submission Checks Completed
24 Feb 2022Assigned to Editor
24 Feb 2022Submitted to Pediatric Blood & Cancer
27 Feb 2022Reviewer(s) Assigned
28 Mar 2022Review(s) Completed, Editorial Evaluation Pending
28 Mar 2022Editorial Decision: Revise Major
25 May 2022Submission Checks Completed
25 May 2022Assigned to Editor
25 May 20221st Revision Received
30 May 2022Reviewer(s) Assigned
13 Jun 2022Review(s) Completed, Editorial Evaluation Pending
15 Jun 2022Editorial Decision: Accept
20 Jul 2022Published in Pediatric Blood & Cancer. 10.1002/pbc.29877