Provider and Health System Factors Associated with Usage of Long-Acting Reversible Contraception in Adolescents

Journal of Pediatric and Adolescent Gynecology
Anna Jo Bodurtha SmithAnita Gupta Hurwitz

Abstract

Long-acting reversible contraception (LARC) is recommended as first-line contraception for adolescents. Surveys of primary care providers suggest that physician and clinic factors might influence LARC counseling, but their effect on usage is unknown. Our objective was to explore provider and clinic characteristics associated with LARC usage in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We conducted a cross-sectional study of 5363 women ages 15-21 years receiving primary care within a large health system in Massachusetts in 2015. We used data abstracted from electronic medical records to characterize rates of LARC usage. We analyzed the association of provider (specialty, degree, gender, resident status, LARC credentialing) and clinic (Title X funding, onsite LARC provision, onsite obstetrician-gynecologist) factors with adolescents' LARC usage using multivariate logistic regression. Overall, 3.4% (95% confidence interval [CI], 2.9-3.9) of adolescents were documented as currently using a LARC method. Older adolescents were significantly more likely to use a LARC method (adjusted odds ratio, 2.41; 95% CI, 1.62-3.58 for women ages 20-21 years compared with ages 15-17 years). Adolescents w...Continue Reading

Citations

Feb 22, 2018·International Journal of Environmental Research and Public Health·Panagiotis TsikourasGeorge Galazios
Mar 3, 2018·Hospital Pediatrics·Rachel L GoldsteinBonnie Halpern-Felsher
May 15, 2018·Journal of the American Association of Nurse Practitioners·Jessamyn Phillips, Prabjot Sandhu
Sep 15, 2020·Simulation in Healthcare : Journal of the Society for Simulation in Healthcare·Jessica M MadrigalAshlesha Patel
Sep 8, 2021·Journal of Midwifery & Women's Health·Helen MahonyEllen M Daley

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