Donna J. Plonczynski

Lifestyle Physical Activity of Older Rural Women

The purpose of this study was to describe and examine the lifestyle physical activity behaviors (household, leisure, occupational) of older rural women. Background characteristics included demographics, environment, social support, and health. Intrapersonal characteristics included motivation and self-efficacy. The majority of the womens energy expenditure was in the household dimension. Social support was positively associated with household activities. A higher level of leisure physical activity was associated with living within the two small cities and reporting lower levels of health and lower motivation. This research highlights the importance of household physical activity and the contribution of social support for household physical activity, both of which may be important in developing interventions to promote physical activity in older rural women.

My Choice: Navigating Contraception Application Development.

KEY POINTS: A new mobile application (app) is developed that assists a client in navigating through contraceptive choices and disseminates knowledge of long-acting reversible contraceptives (LARCs), with the goal of improving family planning and reducing unintended pregnancies. The tailored choice of contraceptives, including knowledge and access to LARCs, has been demonstrated to reduce the unintended pregnancy rate. The app development process for a client education app that navigates the client through contraceptive choices based on tailored responses is described. T he purpose of this article is to describe the development of an application (app) to assist women in navigating through contraceptive choices and disseminate knowledge of long-acting reversible contraceptives (LARCs), with the goal of improving family planning and reducing unintended pregnancies. The app actively involves women in exploring and identifying preferences, risk factors, and needs for tailored contraceptivemethods. The tailored choice of contraceptives, including knowledge and access to LARCs, has been demonstrated to reduce the unintended pregnancy rate. Family planning prevents pregnancies of adolescents and women that are not planned, timed, or spaced according to their needs and circumstances. Approximately 40% of pregnancies in developing countries are unintended, and interestingly, the rate is higher at 47% in developed countries. In the US, the unintended pregnancy rate is even higher—at 51%. Furthermore, females 19 years or younger have the highest unintended pregnancy rates in the US, and the youngest of these females include those for whom 80% of pregnancies are unintended. Long-acting reversible contraceptives (LARCs) such as the intrauterine device (IUD) and contraceptive implant are highly effective because they prevent gaps in administration while also preventing unintended discontinuation. TheAmericanCollege of Obstetricians and Gynecologists recommends the use of LARCs to prevent unintended pregnancies in adolescents and women as LARCs require minimal attention by the users and are cost-effective. For example, womendo not have to remember to take a daily pill, change a patch weekly or a ring monthly, or receive an injection every 3 months. Long-acting reversible contraceptives are convenient while continuously providing a reliable method of birth control. In the US, usage rates of LARCs are low, especially among younger women and adolescents. It is postulated that a lack of awareness and knowledge about LARCs contributes to their lack of use. It is desirable to encourage the acquisition of knowledge of LARCs to increase their use and decrease the unintended pregnancy rate. Availability and quality

The Impact of Personal Characteristics on Contraceptive Choices and Use Over 5 years

Worldwide, there is an unintended pregnancy rate of 40%. That rate is higher in some areas, such as in the United States—where it is nearly 50%. These pregnancies have potentially negative outcomes for the mother and child that include health, economic, social, and psychological aspects. Long-acting reversible contraceptives (LARCs) are highly reliable methods for family planning. Identifying personal characteristics associated with choosing LARCs will better address the unintended pregnancy rates. The purpose of this research project was to evaluate characteristics of adolescents and women at high risk for unintended pregnancies by (a) describing the use of a LARC and selected personal characteristics for the years 2009 and 2014 and (b) exploring relationships among LARC choice and selected personal characteristics of clients seeking family planning services. A retrospective chart review was conducted on 268 randomly selected records, half of which were each from the years 2009 and 2014. One Midwestern U.S. family planning clinic was the site of the research. The characteristics used in the chart reviews were derived from the literature and Healthy People 2020 goals. Key differences between the years 2009 and 2014 included a significant increase in the number of LARCs prescribed to high-risk women. There was a significant relationship between the choice of a LARC and having used one in the past. Personal characteristics influencing LARC birth control choice included White, Hispanic females, those with a history of a teen pregnancy, those who experienced any previous pregnancy or live birth, and those below the poverty level. The findings indicate the importance of educating clients on LARC options. To foster initial use of a LARC, an application, based on the findings of this study, has been developed that provides individualized choices and education on contraceptive methods including LARCs.