142nd APHA Annual Meeting and Exposition

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Providing Long-Acting Reversible contraception services In the school-based health center setting: Key themes for facilitating implementation

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014

Kelly Gilmore, BA, MPHc , School of Public Health Department of Health Services, University of Washington, Seattle, WA
Andrea Hoopes, MD , Department of Pediatrics, Division of Adolescent Medicine, University of Washington, Seattle, WA
Janet Cady, MN, ARNP , School-Based Health Program, Neighborcare Health, Seattle, WA
Sarah Prager, MD , UW Department of Obstetrics and Gynecology, University of Washington
Anne-Marie Amies-Oelschlager, MD , University of Washington Department of Obstetrics and Gynecology, University of Washington
  
Background: Teen pregnancy is a significant public health problem in the United States, causing academic, developmental, and financial hardships for teen mothers and their children. Sixty-eight per one thousand teens will become pregnant before age twenty; Eighty percent of these pregnancies are unintentional. Long-Acting Reversible Contraceptive (LARC) devices have emerged as highly effective and safe means of contraception for adolescents, with the potential to significantly reduce adolescent pregnancy. School-based clinics are uniquely positioned to reach adolescents at risk for unplanned pregnancy, yet few school-based health centers in the United States offer LARC methods on-site or actively encourage LARC use in teens. The purpose of this project was to provide LARC counseling, placement and removal in a school setting and to identify key themes that facilitated LARC implementation.

Methods: Fourteen key informant interviews were conducted with individuals involved in the implementation of LARC services, their positions ranging from school-based health providers to public health officials. Interview transcripts were analyzed for themes using a priori codes and ATLAS.ti qualitative software.

Results: Key themes for implementation included: A respected individual to champion LARC services, clear communication about risks and benefits of LARC in adolescents, establishment of public and private community partnerships, and comprehensive provider trainings. LARC services were implemented successfully in several school- based clinics.

Conclusion: LARC counseling and device placement can be implemented in a school- based setting with individual and community support and comprehensive provider trainings. Ongoing efforts to evaluate and disseminate this model of LARC service delivery are currently underway. 

Learning Areas:

Administration, management, leadership
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe key barriers and facilitating factors in the Neighborcare Health school-based LARC service delivery intervention. List LARC recommendations from professional organizations that identify LARC methods as appropriate and safe for adolescents. Identify public, private, and community partnerships that made the Neighborcare LARC intervention possible and eventually expanded LARC service delivery to all Seattle Public Schools school-based health sponsors.

Keyword(s): Adolescents, School-Based Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This paper reflects one aspect of my year long capstone project where I evaluated a LARC method service delivery intervention in two low-income Seattle area high schools. I conducted the key informant interviews and coordinated the coding and analysis with another student under the supervision of my faculty and capstone supervisors.
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.

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