Views and experiences of long-acting reversible contraception among ethnic minorities in high-income countries: a systematic review of qualitative studies
Views and experiences of long-acting reversible contraception among ethnic minorities in high-income countries: a systematic review of qualitative studies
Background Ethnic minorities in high-income countries have higher rates of unintended pregnancies but are less likely to use highly efficacious long-acting reversible contraception (LARC). The reasons for this are unclear. Aim To understand the views and experiences of ethnic minorities within high-income countries about LARC. Methodology Medline, CINAHL, EMBASE and Sociological Abstracts were searched systematically to find qualitative articles about views on LARC. Titles and abstracts were screened to select qualitative studies about LARC whose participants were mainly from ethnic minorities in high-income countries. Quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) tool. Thematic synthesis was conducted. Results Seventeen studies (19 articles) met the inclusion criteria, 14 of which were from the USA (227 participants identified as Latina, 222 Black, 15 multiracial, 4 Asian). Two studies included 32 Chinese women in the UK and Australia and one included 20 Aboriginal women in Australia. Factors influencing uptake of LARC included side effects, convenience, and perceived efficacy of LARC compared with other methods; women's ideas, concerns and expectations; and external influences (partner, family/friends, health professionals and society). Convenience of LARC, control over reproductive decisions, and desire to prevent pregnancy were the main facilitators. Barriers included specific cultural concerns about irregular bleeding, concerns about racial discrimination, and family/friends having negative views on LARC. Conclusions Ethnic minority women often have additional needs and concerns about LARC compared with the White majority. Further research is needed to develop and evaluate customised respectful counselling on contraception options for ethnic minority women and their partners.
long-acting reversible contraception, qualitative research
53-66
Ahmed, Sumayyah
68242320-3290-414e-9350-a29bfce4d3c2
McLoughlin Dymond, Abigail
d19d113e-54f9-46ab-acb2-c49c4a3ea436
Correa, Michele
c19fc57e-23f5-4533-bc38-99f68abba028
Willcox, Merlin L.
dad5b622-9ac2-417d-9b2e-aad41b64ffea
10 November 2023
Ahmed, Sumayyah
68242320-3290-414e-9350-a29bfce4d3c2
McLoughlin Dymond, Abigail
d19d113e-54f9-46ab-acb2-c49c4a3ea436
Correa, Michele
c19fc57e-23f5-4533-bc38-99f68abba028
Willcox, Merlin L.
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Ahmed, Sumayyah, McLoughlin Dymond, Abigail, Correa, Michele and Willcox, Merlin L.
(2023)
Views and experiences of long-acting reversible contraception among ethnic minorities in high-income countries: a systematic review of qualitative studies.
BMJ Sexual and Reproductive Health, 50 (1), , [201864].
(doi:10.1136/bmjsrh-2023-201864).
Abstract
Background Ethnic minorities in high-income countries have higher rates of unintended pregnancies but are less likely to use highly efficacious long-acting reversible contraception (LARC). The reasons for this are unclear. Aim To understand the views and experiences of ethnic minorities within high-income countries about LARC. Methodology Medline, CINAHL, EMBASE and Sociological Abstracts were searched systematically to find qualitative articles about views on LARC. Titles and abstracts were screened to select qualitative studies about LARC whose participants were mainly from ethnic minorities in high-income countries. Quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) tool. Thematic synthesis was conducted. Results Seventeen studies (19 articles) met the inclusion criteria, 14 of which were from the USA (227 participants identified as Latina, 222 Black, 15 multiracial, 4 Asian). Two studies included 32 Chinese women in the UK and Australia and one included 20 Aboriginal women in Australia. Factors influencing uptake of LARC included side effects, convenience, and perceived efficacy of LARC compared with other methods; women's ideas, concerns and expectations; and external influences (partner, family/friends, health professionals and society). Convenience of LARC, control over reproductive decisions, and desire to prevent pregnancy were the main facilitators. Barriers included specific cultural concerns about irregular bleeding, concerns about racial discrimination, and family/friends having negative views on LARC. Conclusions Ethnic minority women often have additional needs and concerns about LARC compared with the White majority. Further research is needed to develop and evaluate customised respectful counselling on contraception options for ethnic minority women and their partners.
Text
Revised Manuscript - Main Document
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More information
Accepted/In Press date: 30 September 2023
e-pub ahead of print date: 10 November 2023
Published date: 10 November 2023
Additional Information:
Funding Information:
MLW’s salary was funded by the National Institute for Health and Care Research (NIHR) (grant NIHR302412). The authors did not receive a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.
Keywords:
long-acting reversible contraception, qualitative research
Identifiers
Local EPrints ID: 484658
URI: http://eprints.soton.ac.uk/id/eprint/484658
ISSN: 2515-1991
PURE UUID: 959b3077-6693-447d-a838-9b63c396f455
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Date deposited: 20 Nov 2023 17:33
Last modified: 18 Mar 2024 03:39
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Contributors
Author:
Sumayyah Ahmed
Author:
Abigail McLoughlin Dymond
Author:
Michele Correa
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