Association between Providers' Attitudes toward and Clients' Use of LARCs at Title X Clinics in Texas

Despite evidence of the superior comparative effectiveness of long-acting reversible contraceptives (LARCs), providers seldom recommend LARCs as a suggested method of birth control. Few studies have evaluated the relationship between providers' attitudes about LARCs and clients' LARC use. This study examines if LARC use varies by type of family planning agency and by providers' LARC attitudes. This sample (n=102) consists of providers at family planning clinics in Texas that received Title X funding in 2008. Survey data was linked to the Texas Family Planning Annual Report (FPAR) on clients' LARC use by agency. Statistically significant differences were found in the percentage of clients using LARCs by agency type. Clients at academic and community-based agencies use LARCs most frequently compared to clients in other family planning agencies. Measures of association were used to identify relationships among providers' attitudes toward LARCs by agency type and with clients' use. Academic-affiliated providers viewed hormone implants favorably due to their reversibility (r = .24, p < .01) and longevity (r = .20 p < .04). Furthermore, attitudes about the reversibility (r = .25, p < .01) and longevity (r = .21, p < .03) of hormone implants were related to the percentage of clients who chose hormone implants. These findings can inform trainings which highlight the importance that providers' knowledge and attitudes about LARCs have for clients' use.