Online Program

Increasing Adolescent Access to Long-Acting Reversible Contraception

Monday, November 2, 2015

Deborah Rinehart, PhD, Health Services Research MC 3240, Denver Health, Denver, CO
Tara Thomas-Gale, MPH, Community Health Services, Denver Health, Denver, CO
Brandy Mitchell, ANP, WHNP, Community Health Services, Denver Health, Denver, CO
Michael Durfee, MSPH, Denver Health, denver, CO
Kari Kuka, M.S., Business Development, Denver Health and Hospital Authority, Denver, CO
study design: A dataset was created to identify adolescents who received a LARC between January 2012 and December 2014. LARC method and removal were determined using retrospective administrative data and confirmed through chart review. 

population studied: This study included 2,169 unique patients aged 15 to 19, with 20% seen at school-based clinics and 80% at community based clinics.  Almost three-quarters (73%) were Hispanic and most had public insurance (58%) or were uninsured (39%). 

principal findings: Over the three years 2,283 LARCs were inserted (20% IUDs and 80% contraceptive implants), with increased numbers each year: 598 in 2012; 690 in 2013; and 995 in 2014.  Outcome data examining expulsions and removals at 12 months post-insertion will also be presented.

conclusions:  Initial findings suggest implementation of provider LARC trainings, health education and removal of cost barriers has led to increased uptake of LARC methods among adolescents.    These efforts have most likely significantly contributed to the 59% decrease in teen birth rates in Denver over the past decade.  Additionally, identifying predictors of removals among this population will provide important information to better tailor counseling efforts.

implications for policy and practice:   Providing patient education and decreasing access barriers to LARC methods is effective in increasing method uptake and an effective strategy in reducing rates of unintended pregnancies among adolescents.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Describe a program that increased access to Long-Acting Reversible Contraception (LARC) in community health and school based clinics. Discuss LARC uptake across the two settings as well as removal rates.

Keyword(s): Teen Pregnancy, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Practice Administrator with Denver Health, I lead implementation of family planning services for its safety-net health system, comprised of primary care, mobile and school-based clinics. Most recently, I presented on the utilization of a health educator model to increase family planning in community health centers at the 2014 City Match conference. My scientific interests include reproductive health access and utilization of services.
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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