Health Care Provider Attitudes About the Safety of ‘Quick Start’ Initiation of Long-Acting Reversible Contraception for Adolescents

Details

• Alternative Title:
  J Pediatr Adolesc Gynecol
• Personal Author:
  Morgan, I.A. ; Zapata, L.B. ; Curtis, K.M. ; Whiteman, M.K.
• Description:
  Study Objective:
  
  To identify characteristics associated with provider attitudes on the safety of ‘Quick Start’ initiation of long-acting reversible contraception (LARC) for adolescents.
  
  Study Design, Setting, and Participants:
  
  We conducted a cross-sectional survey of providers in public-sector health centers and office-based physicians (n = 2,056) during 2013–2014.
  
  Results:
  
  Overall, the prevalence of considering ‘Quick Start’ initiation of LARC for adolescents as safe was 70.9% for implants and 64.5% for intrauterine devices (IUDs). Among public-sector providers, those not trained in implant or IUD insertion had lower odds of perceiving the practice safe (aOR 0.32 95% CI 0.25–0.41 for implants; aOR 0.42 95% CI 0.32–0.55 for IUDs), whereas those practicing at health centers that did not receive Title X funding had lower odds of perceiving the practice safe for IUDs (aOR 0.77 95% CI 0.61–0.98). Among office-based physicians, lack of training in LARC insertion was associated with lower odds of perceiving ‘Quick Start’ initiation to be safe for IUDs (aOR 0.31 95% CI 0.12–0.77). Those specializing in adolescent medicine had higher odds of reporting ‘Quick Start’ initiation of LARC as safe (implants, aOR 2.21 95% CI 1.23–3.98; IUDs, aOR 3.37 95%CI 1.39–8.21) compared with obstetrician-gynecologists.
  
  Conclusions:
  
  Approximately two-thirds of providers considered ‘Quick Start’ initiation of LARC for adolescents safe; however, there were differences by provider characteristics (e.g., Title X funding, training in LARC insertion, specialty). Targeted LARC insertion training and dissemination of evidence-based family planning guidance and implementation into facility and practice-level policies may increase access to ‘Quick Start’ initiation of LARC for adolescents.
  
  
• Subjects:
  Adolescent Attitude Of Health Personnel Contraceptive Agents, Female Cross-Sectional Studies Family Planning Services Female Humans Intrauterine Devices Long-Acting Reversible Contraception Surveys And Questionnaires
• Keywords:
  Adolescents Contraceptive Implant Family Planning Guidance Intrauterine Devices (Cu-IUDs And LNG-IUDs) Long-acting Reversible Contraception (LARC) Same-day Initiation Teens ‘Quick Start’
• Source:
  J Pediatr Adolesc Gynecol. 32(4):402-408
• Pubmed ID:
  30731216
• Pubmed Central ID:
  PMC6717043
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  32
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:1290a82693bddf5df7f9c9357f26ff7ac3e9e4b692b8271b49351d84dbe04acb7ee7e628dbdb3e49702ca0adeec26eea32ea19766044022e9f21cd9cb19355fd
• Download URL:
  https://stacks.cdc.gov/view/cdc/81079/cdc_81079_DS1.pdf
• File Type:
  [PDF - 94.68 KB ]