Reductions in pregnancy rates in the USA with long-acting reversible contraception: a cluster randomised trial

How Much Can Expanding Access to Long-Acting Reversible Contraceptives Reduce Teen Birth Rates?

“…To the extent that teens are afraid to use private insurance to purchase birth control, the future costs of LARCs are likely to continue to be a significant financial barrier to access. 11 The importance of this barrier is documented in Harper et al (2015), which studies LARC take-up among 18-25-year-old women in a randomized control trial that provided clinics with evidence-based training on on how to counsel patients and how to insert IUDs and implants. Harper et al (2015) also considers pregnancy, though their estimates are based on only 80 additional women choosing LARCs at treatment clinics.…”

“…11 The importance of this barrier is documented in Harper et al (2015), which studies LARC take-up among 18-25-year-old women in a randomized control trial that provided clinics with evidence-based training on on how to counsel patients and how to insert IUDs and implants. Harper et al (2015) also considers pregnancy, though their estimates are based on only 80 additional women choosing LARCs at treatment clinics. Moreover, they do not discuss the degree to which participating clinics and participating individuals from these clinics compare to the broader populations from which they were drawn, which raises additional concerns about generalizability.…”

Strengthening implant provision and acceptance in South Africa with the ‘Any woman, any place, any time’ approach: An essential step towards reducing unintended pregnancies

“…Following the training, twice as many women chose a LARC method and subsequent rates of unintended pregnancy were cut by 50% compared with controls. [28] Training in this and other instances have included orientation to tools such as procedural checklists, contraceptive effectiveness charts, clinical case discussions, practical training with anatomical models and audiovisual materials. [29] To be effective, however, training does need to be carefully planned and accompanied by other interventions to strengthen service delivery.…”

Long-Acting Reversible Contraception

“…In a cluster-randomized trial involving 40 reproductive health clinics across the United States, intervention clinics received training on contraception counseling and on insertion of IUDs and implants, and control clinics provided standard care. 46 Higher percentages of women at the intervention clinics than at the control clinics chose LARC methods (28% vs. 17%; odds ratio, 2.2; 95% confidence interval, 1.6 to 3.1). 46 The Colorado Family Planning Initiative used private funding to procure LARC methods, to train providers and staff on provision of LARC methods, and to provide technical assistance with billing and management issues.…”

“…46 Higher percentages of women at the intervention clinics than at the control clinics chose LARC methods (28% vs. 17%; odds ratio, 2.2; 95% confidence interval, 1.6 to 3.1). 46 The Colorado Family Planning Initiative used private funding to procure LARC methods, to train providers and staff on provision of LARC methods, and to provide technical assistance with billing and management issues. 47 LARC use among 15-to-24-year-old persons in Colorado increased from 5% to 19% over the course of 2 years.…”