Online Program

Who chooses long-acting reversible contraception (LARC)? patient decision-making around birth control methods in two states

Monday, November 4, 2013

Abigail Arons, MPH, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
M. Antonia Biggs, PhD, Advancing New Standards in Repro Health, University of California, San Francisco, Oakland, CA
Heather Hirsch, MA, Philliber Research Associates, Accord, NY
Claire Brindis, Dr. P.H, M.P.H., University of California, San Francisco, Bixby Center for Global Reproductive Health /PRL Institute for Health Policy Studies, San Francisco, CA
Among U.S. women, use of long-acting, reversible contraception (LARC), including the IUD or implant, is quite low compared to other, less effective birth control methods. While low knowledge about LARC methods may contribute to low uptake, there is little research on what factors my influence patients' decision-making around contraception. To improve knowledge, acceptance, and utilization of LARC, grantees in Colorado and Iowa received dedicated funding to train providers, advertise LARC methods, and provide subsidized devices. Patients receiving reproductive health services at these sites completed surveys regarding their birth control choices, reasons for choosing or not choosing LARC methods, and satisfaction with their clinic visit. Data were analyzed using STATA. Most of the women who completed surveys (n=763) were in their 20s (55%), non-Hispanic white (53%), and U.S. born (82%). Over half (56%) reported leaving the clinic with a hormonal method (pills, patch, ring, or shot), 15% left with an IUD, 9% left with an implant, and 13% left with no method. There were no significant demographic differences among women who chose LARC compared to women who chose other methods. Women who chose LARC methods were significantly more likely to be satisfied with their clinic visit than other women, including having all their questions answered, receiving enough information about birth control methods, and receiving the method that they wanted (OR: 1.64, CI: 1.16-2.31). Results indicate that providing women with more information about birth control methods may improve both patient satisfaction and adoption of LARC methods.

Learning Areas:

Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe an innovative initiative to increase LARC use in two states. Assess reasons women choose different birth control methods and factors that may influence this decision-making process. Discuss the association between patient satisfaction, patient knowledge, and patient decision-making regarding birth control methods.

Keyword(s): Contraception, Decision-Making

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a project director for two statewide initiatives to reduce unintended pregnancy and address barriers to utilization of long-acting reversible contraception methods. I have conducted research and evaluation in reproductive health for over 10 years.
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.