UNDERSTANDING REPRODUCTIVE HEALTH EDUCATION NEEDS AMONG YOUNG WOMEN IN A HEALTH COACHING PROGRAM TO IMPROVE CONTRACEPTIVE CONTINUATION

Purpose: Young women under the age of 25 years have high rates of contraceptive discontinuation, which is a key factor driving high rates of unintended pregnancy in this population. Although several evidence-based interventions to reduce contraceptive discontinuation exist, none are tailored to meet adolescent and young adult women's unique educational and developmental needs. Among young women enrolled in a feasibility pilot of a health coaching intervention to improve contraceptive continuation, we examined the types of reproductive health topics young women were interested in learning about. Methods: Sexually active young women ages 14-21 years who initiated a new contraceptive method were recruited between March and December 2017. At baseline, participants were asked to rank nine sexual health topics they wanted to discuss during health coaching sessions. Topics included information about one's new contraceptive method, contraceptive adherence tools, contraceptive myths and facts, condom negotiation, healthy relationships, teen pregnancy risks and prevention, bleeding and weight gain side effects, and sexually transmitted diseases (STD). Health coaching sessions were scheduled monthly during the 6 months following contraceptive initiation (five total coaching sessions). At each coaching session, which reproductive health topics were discussed was decided collaboratively between participants and health coaches based participant's original ranking at baseline, participant request at the coaching session, or health coach's assessment of participant's critical needs at the coaching visit. Baseline rankings of the nine topics were compared to the frequency ranking of topics actually discussed during coaching visits. Congruency between the order of topics ranked at baseline and those actually discussed at each visit was assessed. Results: Of the 33 participants who completed a baseline, 28 (84.8%) completed at least one health coaching session. At baseline, two topics tied as top-ranking: weight gain side effects (n=15) and teen pregnancy prevention (n=15). The second most frequent topic was STDs (n=14), while bleeding side effects ranked third (n=11). Three commonly discussed topics at coaching sessions were information about one's new contraceptive method (n=18), weight gain side effects (n=16), and STDs (n=15). These were commonly discussed because participants had questions/concerns, or gaps in knowledge about their chosen method, about weight gain/loss,