Can Pediatricians Provide Long-Acting Reversible Contraception?

Area of Science:

• Adolescent Health
• Contraception
• Pediatric Practice

Background:

• 40% of US high school students are sexually active.
• Few adolescents use highly effective long-acting reversible contraceptives (LARCs).
• Pediatricians are key providers but rarely offer LARCs.

Purpose of the Study:

• To understand barriers and opportunities for LARC provision by community pediatricians.
• To identify pragmatic factors influencing LARC provision.

Main Methods:

• Qualitative descriptive study using semistructured interviews.
• 23 pediatricians interviewed in a Midwestern city.
• Coding schema applied using a priori and open coding.

Main Results:

• Key challenges include limited motivation for on-site LARC provision, low patient interest, lack of pediatrician training, and inadequate office infrastructure.
• Pediatricians are motivated to provide high-quality adolescent care.
• Improvements in these areas can facilitate LARC provision.

Conclusions:

• Current practice norms limit LARC provision by pediatricians.
• Recommendations include enhanced training for providers, increased patient education to boost demand, and systemic changes for better referrals and on-site placement.
• Increased LARC access in pediatric settings is achievable.