How Long-Acting Reversible Contraception Knowledge, Training, and Provider Concerns Predict Referrals and Placement

Area of Science:

• Reproductive Health
• Contraception
• Medical Education

Background:

• Long-acting reversible contraception (LARC) methods, such as subdermal implants and intrauterine devices (IUDs), are highly effective in preventing unintended pregnancies.
• Despite their efficacy, various barriers hinder LARC placement among healthcare providers.
• Understanding these barriers is crucial for tailoring medical education and improving LARC accessibility.

Purpose of the Study:

• To analyze the interrelationships between different barriers affecting LARC placement.
• To identify which barriers significantly predict LARC referral and placement when considered concurrently.
• To assess persistent barriers to LARC placement, even after provider training.

Main Methods:

• A survey was administered to 224 healthcare providers in Ohio, including obstetricians, gynecologists, family physicians, pediatricians, internists, nurse practitioners, and nurse midwives.
• The survey included Likert-type items on barriers, a knowledge test, and questions on LARC referral and placement practices.
• Data analysis involved correlations, odds ratios, and independent samples t tests to examine relationships between barriers, training, and LARC utilization.

Main Results:

• Provider knowledge, training, and concerns regarding LARC placement were found to be interconnected.
• While training positively predicted placement, it negatively predicted referral when other barriers were controlled.
• A significant percentage of trained providers still referred or did not place LARCs, reporting greater barriers than those who did place them.

Conclusions:

• LARC knowledge, training, and provider concerns are interdependent factors influencing LARC adoption.
• Even with training, substantial barriers prevent some providers from offering LARC, highlighting the need for comprehensive strategies.
• Addressing the multifaceted nature of these barriers is essential to enhance LARC provision and availability.