Isabel A Morgan1, Lauren B Zapata2, Kathryn M Curtis3, Maura K Whiteman3. 1. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee. 2. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: lzapata@cdc.gov. 3. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
STUDY OBJECTIVE: To identify characteristics associated with provider attitudes on the safety of "Quick Start" initiation of long-acting reversible contraception (LARC) for adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We conducted a cross-sectional survey of providers in public-sector health centers and office-based physicians (n = 2056) 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 (adjusted odds ratio [aOR], 0.32; 95% confidence interval [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. CONCLUSION: Approximately two-thirds of providers considered "Quick Start" initiation of LARC for adolescents safe; however, there were differences according to provider characteristics (eg, 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 might increase access to "Quick Start" initiation of LARC for adolescents.
STUDY OBJECTIVE: To identify characteristics associated with provider attitudes on the safety of "Quick Start" initiation of long-acting reversible contraception (LARC) for adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We conducted a cross-sectional survey of providers in public-sector health centers and office-based physicians (n = 2056) 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 (adjusted odds ratio [aOR], 0.32; 95% confidence interval [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. CONCLUSION: Approximately two-thirds of providers considered "Quick Start" initiation of LARC for adolescents safe; however, there were differences according to provider characteristics (eg, 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 might increase access to "Quick Start" initiation of LARC for adolescents.
Authors: Cynthia C Harper; Jillian T Henderson; Tina R Raine; Suzan Goodman; Philip D Darney; Kirsten M Thompson; Christine Dehlendorf; J Joseph Speidel Journal: Fam Med Date: 2012-10 Impact factor: 1.756
Authors: Suzan Goodman; Sarah K Hendlish; Courtney Benedict; Matthew F Reeves; Madeline Pera-Floyd; Anne Foster-Rosales Journal: Contraception Date: 2008-06-18 Impact factor: 3.375
Authors: Cynthia C Harper; Maya Blum; Heike Thiel de Bocanegra; Philip D Darney; J Joseph Speidel; Michael Policar; Eleanor A Drey Journal: Obstet Gynecol Date: 2008-06 Impact factor: 7.661
Authors: Anna W Brittain; Heather D Tevendale; Trisha Mueller; Aniket D Kulkarni; Dawn Middleton; Michela L B Garrison; Mary R Read-Wahidi; Emilia H Koumans Journal: J Community Health Date: 2020-06
Authors: Andrew G Corley; Andrea Sprockett; Dominic Montagu; Nirali M Chakraborty Journal: Int J Environ Res Public Health Date: 2022-05-27 Impact factor: 4.614
Authors: Alison M El Ayadi; Corinne H Rocca; Sarah H Averbach; Suzan Goodman; Philip D Darney; Ashlesha Patel; Cynthia C Harper Journal: J Pediatr Adolesc Gynecol Date: 2020-12-01 Impact factor: 2.046