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. Author manuscript; available in PMC: 2014 Feb 12.
Published in final edited form as: J Adolesc Health. 2013 Mar;52(3):376–377. doi: 10.1016/j.jadohealth.2012.10.277

Knowledge Is Necessary but Insufficient to Change Provider Attitudes About Intrauterine Devices for Adolescents

Susan E Rubin 1
PMCID: PMC3921958  NIHMSID: NIHMS546817  PMID: 23427787

To the Editors

I read with much interest the article by Kohn [1] et al. describing the results from a survey of New York City school based health center staff designed to identify barriers to intra-uterine device (IUD) provision for adolescents. I am pleased that Kohn et al. based their survey on a very similar survey my colleagues and I conducted with a national sample of family physicians in 2008 [2,3]. We too found that providers, in this case family physicians, have knowledge gaps and attitudes that likely result in missed opportunities to provide IUDs to all eligible patients including adolescents. Kohn found as we did that those providers who have better IUD knowledge and who recommend IUDs are more likely to perceive that their patients are receptive to discussing IUDs. It is encouraging that, as compared with our sample, Kohn’s clinician responders appear to have better IUD knowledge. This likely reflects the secular trend of increased IUD use in the United States [4] and dissemination of research supporting the safety and efficacy of IUDs across the reproductive lifespan [5]. In fact, a recent study found that increasing IUD use in adolescents can decrease the adolescent pregnancy rate [6].

However Kohn’s study also finds, as we did, that the persistence of a gap between provider IUD knowledge and their attitudes around actually providing or counseling about IUDs. This lends more weight to Kohn’s conclusion that increased knowledge about IUDs may be insufficient to increase IUD provision. We must consider that in order to counterbalance provider attitudes there is also a need to identify and discuss potential biases and/or assumptions affecting our contraception counseling.

This is a commentary on article Kohn JE, Hacker JG, Rousselle MA, Gold M. Knowledge and likelihood to recommend intrauterine devices for adolescents among school-based health center providers. J Adolesc Health. 2012;51(4):319-24.

References

  • 1.Kohn JE, Hacker JG, Rousselle MA, Gold M. Knowledge and likelihood to recommend intrauterine devices for adolescents among school-based health center providers. J Adolesc Health. 2012;51:319–24. doi: 10.1016/j.jadohealth.2011.12.024. [DOI] [PubMed] [Google Scholar]
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