267006 Perceived contraindications to IUD and implant use among family planning providers: Misalignment with ACOG guidelines and implications for training

Tuesday, October 30, 2012 : 3:30 PM - 3:45 PM

Ashley Philliber, MS , Philliber Research Associates, Accord, NY
Heather Hirsch, MA , Philliber Research Associates, Accord, NY
Rita Turner, MS , Philliber Research Associates, Accord, NY
Susan Philliber, PhD , Philliber Research Associates, Accord, NY
In 2010, 159 clinicians in 47 family planning agencies across Colorado and Iowa were surveyed as part of statewide initiatives to reduce unintended pregnancy. The initiatives particularly focused on the promotion of intrauterine devices and implants. Surveys of these physicians, physicians' assistants, nurse practitioners, certified nurse midwives, and registered nurses, asked if they considered intrauterine devices and implants safe and reliable for various groups of women. The resultant data are compared with guidelines for use of these methods provided in July of 2011 by the American College of Obstetrics and Gynecology (ACOG). Specifically, these clinicians' views are not entirely in alignment with ACOG recommendations, particularly in their beliefs that these methods should not be used immediately post-partum or post-abortion or when there are issues of menorrhagia or dysmenorrhea. Notable percentages of these clinicians were also hesitant to recommend these effective methods for other groups of patients, approved for use by ACOG. While it has been repeatedly recognized that the cost of these methods is a barrier to their adoption, these data suggest that there are continuing provider barriers to their use as well. The paper concludes with suggestions of specific topics that might be included in professional and in-service training for family planning providers.

Learning Areas:
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences

Learning Objectives:
1. Identify differences between ACOG guidelines and clinicians’ views of IUDs and implants. 2. Assess barriers to family planning providers recommending IUDs and implants. 3. Develop a training plan for family planning providers.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in the field of research evaluation, particularly related to unplanned and teen pregnancy prevention, in some way for 15 years. This project is the work of a strong team of researchers including Susan Philliber, PhD. My main focus and interest is in unplanned pregnancy prevention although I work with a wide range of nonprofit organizations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.