142nd APHA Annual Meeting and Exposition

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IUC for EC: Beliefs and practices among reproductive health center staff

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 11:06 AM - 11:18 AM

Julia Kohn, PhD MPA , Research Department, Planned Parenthood Federation of America, New York, NY
Sandy Worthington, MSN WHNP-BC CNM , Medical Services Department, Planned Parenthood Federation of America, New York, NY
Kay Armstrong, MS , Independent Consultant, New York, NY
Scott J. Spear, MD , University of Houston, Houston, TX
Deborah Nucatola, MD , Medical Services Department, Planned Parenthood Federation of America, New York, NY
Audio (mp3) recording Recorded Presentation (mp4)
Background/Significance  The Copper IUC is the most effective method of emergency contraception (EC). If inserted within five days after unprotected intercourse it is 99.9% effective and provides ongoing contraception for up to 12 years. Yet it is underutilized as EC. This may be due to gaps in provider knowledge, attitudes toward IUCs, or systems barriers. 

Objective/Purpose  The objective was to assess practices and beliefs about IUC for EC among health center staff, and to determine potential barriers to provision. This was a baseline assessment for a demonstration project to increase provision of IUCs for EC.

Methods  Eighty-nine staff at nine geographically diverse health centers were surveyed online in 2013. One-third were clinicians (34%); the remainder were health center assistants (21%), front desk staff (17%), managers (10%), or others. The mean age was 38 years.

Results  Over half (54%) of respondents agreed that clients are receptive to learning about IUCs for EC.  16% percent agreed that clients would want an IUC removed within 6 months. 55% agreed that providing same-day insertion is difficult due to staffing issues, and 45% agreed that cost is a barrier for clients. A significant number responded “Unsure” to questions. 19% reported having some concerns about providing IUC for EC. 32% reported no clients receiving IUC for EC in the past six months.

Discussion/Conclusions  Results suggest insufficient information and perceived barriers to providing the IUC for EC. Additional training and systems improvements may be necessary to increase provision.  Six-month follow-up results will be available for the presentation. 

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Identify the most effective method of emergency contraception. Describe at least two key findings of the provider survey. Identify one potential barrier to providing the Copper IUC for EC and at least one way to address it.

Keyword(s): Contraception, Family Planning

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Off-label use of the Copper IUC for emergency contraception will be discussed.

Qualified on the content I am responsible for because: I am the National Director of Research for Planned Parenthood Federation of America and am overseeing the evaluation of the demonstration project on which this research is based.
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.

Back to: 4158.0: Facilitators and barriers to increasing access to emergency contraception