301 - Identifying Barriers to Long-Acting Contraception for Adolescents in the Pediatric Setting

Although Long-Acting Reversible Contraception (LARC) is considered the standard of care for reproductive health in sexually active adolescents, many pediatricians do not regularly provide LARCs to this patient population. LARCs have higher efficacy, higher continuation rates, and higher satisfaction than short acting contraceptives. A current literature review indicates that barriers to provider recommendations for LARC use in adolescents include procedural training, misinformation, time constraints, and availability on site. LARC recommendations by pediatricians may be especially important in communities with higher teen pregnancy rates such as in our local context.

Objective:

The purpose of this study is to gather data on opinions and attitudes of primary care providers that care for adolescent populations in our local context so that we can identify specific barriers that inhibit providers from making LARC recommendations.

Design/Methods:

The research team developed a brief self-administered survey via Qualtrics and sent it to pediatric providers within our county and closely surrounding areas by email. Recipients were identified though the local pediatric society and group pediatric practices. Participants were included in the study if they were mid-level pediatric providers or attending pediatric physicians. Participants were excluded from the study if they were non-pediatric providers or pediatric residents.

Results:

Data includes responses from 23 providers. Data analysis involved descriptive statistics and chi square test of association. Survey participants responded that their main concerns about suggesting contraception to adolescents were patient time constraints (22.86%) followed by lack of training in counseling and insertion (20%), patient confidentiality (14.29%), and other (14.29%). A significant proportion of providers (61.9%) were interested in providing LARCs to their patients (p < 0.01) and 62.5% responded that they would provide LARCs to their patients if they had appropriate training.

Conclusion(s):

Pediatric providers in our local context have concerns about providing contraception despite AAP recommendations and local high prevalence of adolescent sexual activity and teen pregnancy rates. Results from this survey indicate that local barriers to provider recommendation of LARC are similar to what has previously been reported in similar studies. However, in our study the majority of identified barriers could potentially be resolved by provider training and equipping. Many providers are interested in providing LARCs to their patients and would do so if they had appropriate training.