J Pediatr Adolesc Gynecol

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.

30731216

PMC6717043

Journal Article

CC999999/Intramural CDC HHS/United States

CDC Public Access