Contraception Counseling in College Student Health Centers: A Survey of Healthcare Providers [13G]

Abstract

INTRODUCTION: Many of the 20 million college students in the U.S. access contraception through student health centers, but little is known about how college health providers approach contraceptive counseling and provision. METHODS: We surveyed 87 New England college health providers about contraceptive counseling practices and on site availability of contraceptives, especially intrauterine devices and subdermal implants (long-acting reversible contraception= LARC). Providers were also surveyed about their IUD/implant training and comfort level with insertion. Descriptive statistical analyses were conducted using STATA 13.2. RESULTS: Most respondents (57%) were nurse practitioners, 17% were registered nurses, and 11% were medical doctors. Providers ranked oral contraceptive methods as most popular with students and reported that students chose LARC methods less than 10% of the time. Providers felt that IUDs and implants were appropriate methods for this population, however few (<15%) provided LARC methods themselves. Most students had to be referred off-campus for further services. Providers had some experience with LARC training. 75% of providers reported classroom training with IUDs and implants, while 30-50% had hands-on insertion training. Despite these training experiences, nearly all providers reported they were uncomfortable with IUD and implant insertion. Barriers to LARC uptake included insufficient volume or experience, institutional policies, and student unfamiliarity with the methods. CONCLUSION: While college student healthcare providers are enthusiastic about LARC methods, few have insertion experience or are comfortable with follow-up care. Further research should address whether increased on-campus accessibility would increase student uptake as well as development of supplemental college healthcare provider training to increase comfort with LARC insertion.