Access to long-acting reversible contraception among US publicly funded health centers

Details

• Alternative Title:
  Contraception
• Personal Author:
  Bornstein, Marta ; Carter, Marion ; Zapata, Lauren ; Gavin, Loretta ; Moskosky, Susan
• Description:
  Objectives:
  
  Access to a full range of contraceptive methods, including long-acting reversible contraception (LARC), is central to providing quality family planning services. We describe health center-related factors associated with LARC availability, including staff training in LARC insertion/removal and approaches to offering LARC, whether onsite or through referral.
  
  Study Design:
  
  We analyzed nationally representative survey data collected during 2013–2014 from administrators of publicly funded U.S. health centers that offered family planning. The response rate was 49.3% (n=1615). In addition to descriptive statistics, we used multivariable logistic regression to identify health center characteristics associated with offering both IUDs and implants onsite.
  
  Results:
  
  Two-thirds (64%) of health centers had staff trained in all three LARC types (hormonal IUD, copper IUD, implant); 21% had no staff trained in any of those contraceptive methods. Half of health centers (52%) offered IUDs (any type) and implants onsite. After onsite provision, informal referral arrangements were the most common way LARC methods were offered. In adjusted analyses, Planned Parenthood (AOR=9.49) and hospital-based (AOR=2.35) health centers had increased odds of offering IUDs (any type) and implants onsite, compared to Health Departments, as did Title X-funded (AOR=1.55) compared to non-Title X-funded health centers and centers serving a larger volume of family planning clients. Centers serving mostly rural areas compared to those serving urbans areas had lower odds (AOR 0.60) of offering IUD (any type) and implants.
  
  Conclusions:
  
  Variation in LARC access remains among publicly funded health centers. In particular, Health Departments and rural health centers have relatively low LARC provision.
  
  
• Subjects:
  Adolescent Adult Community Health Centers Contraceptive Agents, Female Family Planning Services Female Health Services Accessibility Humans Logistic Models Long-Acting Reversible Contraception Multivariate Analysis Practice Patterns, Physicians' Young Adult

  More +
• Keywords:
  Contraceptive Methods Long-acting Reversible Contraceptives LARC Title X Training
• Source:
  Contraception. 97(5):405-410
• Pubmed ID:
  29253581
• Pubmed Central ID:
  PMC6750753
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  97
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:05d9620302ac7e090cd5c234bbab3e94ebbab748d6f1b90f4632853c537d475e
• Download URL:
  https://stacks.cdc.gov/view/cdc/134174/cdc_134174_DS1.pdf
• File Type:
  [PDF - 80.35 KB ]