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Long-Acting Reversible Contraception

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21. Long-Acting Reversible Contraceptive (LARC) Utilization After Policy Change Increasing Device Reimbursement to Wholesale Acquisition Cost in Louisiana. (PubMed)

Long-Acting Reversible Contraceptive (LARC) Utilization After Policy Change Increasing Device Reimbursement to Wholesale Acquisition Cost in Louisiana. Unintended pregnancies, occurring in nearly one out of every two (45%) pregnancies in the United States, are associated with adverse health and social outcomes for the infant and the mother. The risk of unintended pregnancies is significantly reduced when women use long-acting reversible contraceptives (LARCs), namely intrauterine devices (...) and implants. Inadequate reimbursement for LARC devices may be an access barrier to LARC uptake. In 2014, the Louisiana Department of Health Bureau of Health Services Financing implemented a policy change that increased the Medicaid reimbursement rates for acquiring LARC devices to the wholesale acquisition cost.To examine the association of a Medicaid policy change that increased the long-acting reversible contraceptive (LARC) device reimbursement rate to the wholesale acquisition cost (i.e., price set

2019 American Journal of Obstetrics and Gynecology

22. Factors associated with long-acting reversible contraception use among women Veterans in the ECUUN study. (PubMed)

Factors associated with long-acting reversible contraception use among women Veterans in the ECUUN study. The objective of this study is to understand patient-, provider- and system-level factors associated with long-acting reversible contraception (LARC) use among women Veterans and with receipt of LARC methods within the Veterans Affairs (VA) system.We analyzed data from a national telephone-based survey of 2302 women ages 18-44 receiving primary care in VA. Multivariable regression was used

2019 Contraception

23. Predictors of Discontinuation of Long-Acting Reversible Contraception Before 30 Months of Use by Adolescents and Young Women. (PubMed)

Predictors of Discontinuation of Long-Acting Reversible Contraception Before 30 Months of Use by Adolescents and Young Women. The purpose of the article was to describe adolescent and young women's rates of discontinuation of intrauterine devices (IUDs) and contraceptive implants, the extent to which discontinuation is predicted by baseline factors, reasons for discontinuation, and subsequent contraceptive initiation.We recruited English-speaking women, aged 13-24 years, from a family planning (...) clinic serving clients <25 years old. Participants completed surveys before and after contraceptive initiation visits. We reviewed medical records and contacted participants who initiated use of an IUD or contraceptive implant and assessed contraceptive discontinuation before 30 months of use. We collected follow-up data on duration of use, reasons for discontinuation, and new method selected. We used multivariable regression models to ascertain factors associated with method discontinuation.From

2019 The Journal of Adolescent Health

24. Can a social media campaign increase the use of long-acting reversible contraception? Evidence from a cluster randomized control trial using Facebook. (PubMed)

Can a social media campaign increase the use of long-acting reversible contraception? Evidence from a cluster randomized control trial using Facebook. To test whether an informational campaign carried out on social media increased use of long-acting reversible contraception (LARC).We implemented a stratified cluster randomized control trial to identify the effect of an informational campaign carried out using Facebook advertisements designed to increase knowledge of the efficacy, ease of use

2019 Contraception Controlled trial quality: uncertain

25. Effect of Deploying Trained Community Based Reproductive Health Nurses (CORN) on Long-Acting Reversible Contraception (LARC) Use in Rural Ethiopia: A Cluster Randomized Community Trial. (PubMed)

Effect of Deploying Trained Community Based Reproductive Health Nurses (CORN) on Long-Acting Reversible Contraception (LARC) Use in Rural Ethiopia: A Cluster Randomized Community Trial. To investigate the effect of innovative means to distribute LARC on contraceptive use, we implemented a three arm, parallel groups, cluster randomized community trial design. The intervention consisted of placing trained community-based reproductive health nurses (CORN) within health centers or health posts (...) . The nurses provided counseling to encourage women to use LARC and distributed all contraceptive methods. A total of 282 villages were randomly selected and assigned to a control arm (n = 94) or 1 of 2 treatment arms (n = 94 each). The treatment groups differed by where the new service providers were deployed, health post or health center. We calculated difference-in-difference (DID) estimates to assess program impacts on LARC use. After nine months of intervention, the use of LARC methods increased

2019 Studies in family planning Controlled trial quality: uncertain

26. Long-acting reversible contraceptives for adolescent females: a review of current best practices. (PubMed)

Long-acting reversible contraceptives for adolescent females: a review of current best practices. This review will address the need for adolescent contraception, compare the benefits of long-acting reversible contraceptives (LARC) with non-LARC methods, discuss unique barriers to LARC for adolescents, and provide physicians with latest recommendations for counseling adolescents on contraception.The United States has the highest adolescent birth rate of any developed country at 18.8 births per (...) 1000 females aged 15-19 years. This rate is more than double the rate in France (9/1000) and Spain (9/1000), and nearly 1.6× the rate in the United Kingdom (12/1000). As the most effective and user-independent methods of contraception, LARC have the potential to notably lower the adolescent birth rate. However, despite higher rates of patient satisfaction and continuation with LARC, adolescent LARC usage remains low. Just 4.3% of all American females aged 15-19 years who reported using some form

2019 Current opinion in pediatrics

27. Use of long-acting reversible contraception in a cluster-random sample of female sex workers in Kenya. (PubMed)

Use of long-acting reversible contraception in a cluster-random sample of female sex workers in Kenya. To assess correlates of long-acting reversible contraceptive (LARC) use, and explore patterns of LARC use among female sex workers (FSWs) in Kenya.Baseline cross-sectional data were collected between September 2016 and May 2017 in a cluster-randomized controlled trial in Mombasa. Eligibility criteria included current sex work, age 16-34 years, not pregnant, and not planning pregnancy. Peer (...) educators recruited FSWs from randomly selected sex-work venues. Multiple logistic regression identified correlates of LARC use. Prevalence estimates were weighted to adjust for variation in FSW numbers recruited across venues.Among 879 participants, the prevalence of contraceptive use was 22.6% for implants and 1.6% for intra-uterine devices (IUDs). LARC use was independently associated with previous pregnancy (adjusted odds ratio for one pregnancy, 11.4; 95% confidence interval, 4.25-30.8), positive

2019 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Controlled trial quality: uncertain

28. Integration of contraceptive services into anticoagulation management services improves access to long-acting reversible contraception. (PubMed)

Integration of contraceptive services into anticoagulation management services improves access to long-acting reversible contraception. Integration of services is a promising way to improve access to contraception in sub-Saharan Africa, but few studies have evaluated this strategy to increase access to contraception among women requiring anticoagulation. Our objective was to evaluate a model of care integrating contraceptive counseling and provision within an anticoagulation management clinic (...) in Eldoret, Kenya, to determine the impact on long-acting reversible contraception (LARC) use.We performed a prospective observational study of reproductive-age women referred for integrated services from the anticoagulation management clinic at Moi Teaching and Referral Hospital from March 2015 to March 2016. All participants received disease-specific contraceptive counseling and provision, free reversible methods (excluding hormonal intrauterine devices [IUDs]) and follow-up care. We compared LARC use

2018 Contraception

29. Role of Bridge Contraception in Postpartum Long-Acting Reversible Contraception and Sterilization Fulfillment Rates. (PubMed)

Role of Bridge Contraception in Postpartum Long-Acting Reversible Contraception and Sterilization Fulfillment Rates. To estimate the association of bridge contraception with interval long-acting reversible contraception (LARC) and sterilization fulfillment rates.This is a secondary analysis of a retrospective single-center cohort chart review study examining 1,851 postpartum women who requested LARC or sterilization after discharge. Bridge contraception was requested by 597 of these women (...) , 95% CI 0.95-1.05; adjusted OR 0.96, 95% CI 0.73-1.26).Bridge contraception is associated with increased LARC and sterilization fulfillment after postpartum discharge. Long-acting reversible contraception or sterilization fulfillment after discharge occurred in less than one in four women. Strategies to improve provision of LARC or sterilization before hospital discharge are necessary.

2018 Obstetrics and Gynecology

30. Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate on the Day of Abortion. (PubMed)

Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate on the Day of Abortion. To evaluate whether contraceptive insurance coverage for women who present for an abortion is associated with obtaining long-acting reversible contraception or depot medroxyprogesterone acetate (DMPA) on the day the abortion is completed.We conducted a prospective cohort study of women presenting for medical or surgical abortion at a single health (...) univariable, bivariable, and multivariable analysis to report our findings.Five hundred seventy-five women enrolled in our cohort between September 2015 and April 2016. One hundred twenty-eight (22%) had insurance coverage and 447 (78%) did not. In the group with insurance coverage for contraception, 38% (49/128) received a long-acting reversible contraception method or DMPA compared with 7% (33/447) in the group without insurance coverage for contraception. After adjusting for confounding, women

2017 Obstetrics and Gynecology

31. Postabortion Contraceptive Use and Continuation When Long-Acting Reversible Contraception Is Free. (PubMed)

Postabortion Contraceptive Use and Continuation When Long-Acting Reversible Contraception Is Free. To compare preference for long-acting contraception (LARC) and subsequent use, year-long continuation, and pregnancy among women after induced abortion who were and were not eligible to participate in a specialized funding program that provided LARC at no cost.Between October 2014 and March 2016, we conducted a prospective study of abortion patients at Planned Parenthood in Austin, Texas (located (...) likely to use and continue these methods. Low-income ineligible women were far more likely to use less effective contraception and become pregnant. Specialized funding programs can play an important role in immediate postabortion contraceptive provision, particularly in settings where state funding is limited.

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2017 Obstetrics and Gynecology

32. Effects of immediate postpartum contraceptive counseling on long-acting reversible contraceptive use in adolescents (PubMed)

Effects of immediate postpartum contraceptive counseling on long-acting reversible contraceptive use in adolescents Adolescent pregnancy is a global public health problem, particularly repeated pregnancy. The best strategy to lower prevalence of adolescent pregnancy and repeated pregnancy is promoting highly effective long-acting contraceptive methods along with special counseling programs. Long-acting reversible contraception (LARC) is the ideal contraceptive of choice for adolescents (...) . It is not known whether immediate postpartum contraceptive counseling increases postpartum LARC use in adolescents.To compare LARC use between immediate and conventional postpartum contraceptive counseling and discover predictive factors of postpartum LARC use.This prospective, randomized controlled trial was conducted among postpartum adolescents at Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, from 1 July 2016 to 31 March 2017

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2017 Adolescent health, medicine and therapeutics Controlled trial quality: predicted high

33. Changes in the use of effective and long-acting reversible contraception in Vietnam. (PubMed)

Changes in the use of effective and long-acting reversible contraception in Vietnam. To calculate the prevalence and identify correlates of unmet need for contraception and to assess whether prevalence of use of effective contraception and long-acting reversible contraception (LARC) has changed over time among married or cohabiting, reproductive-age women in Vietnam.Study population was drawn from nationally representative Multiple Indicator Cluster Surveys conducted in 2000, 2006, 2011 (...) for contraception should be used to inform interventions to prevent unintended pregnancy.Although the prevalence of unmet need for contraception was low (4.3%) in 2014, the use of effective contraception and long-acting reversible contraception declined among reproductive-age, married or cohabiting women in Vietnam from 2000 to 2014. This finding is particularly striking given the economic growth in the nation during this time frame.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 Contraception

34. Long-Acting Reversible Contraception Free of Charge, Method Initiation, and Abortion Rates in Finland. (PubMed)

Long-Acting Reversible Contraception Free of Charge, Method Initiation, and Abortion Rates in Finland. To evaluate whether a public program providing long-acting reversible contraceptive (LARC) methods free of charge increases the LARC initiation rate and reduces the unintended pregnancy rate in the general population.Since 2013, all women in Vantaa, Finland, have been entitled to 1 LARC method free of charge. With time-series analysis between 2000 and 2015, we assessed whether this public (...) uptake of LARC methods and fewer abortions in the population. Public Health Implications. Entitling the population to LARC methods free of charge is an effective means to reduce the unmet need of contraception and the need for abortion, especially among women younger than 25 years.

2018 American Journal of Public Health

35. Racial and Ethnic Differences in Patterns of Long-Acting Reversible Contraceptive Use in the United States, 2011-2015. (PubMed)

Racial and Ethnic Differences in Patterns of Long-Acting Reversible Contraceptive Use in the United States, 2011-2015. To investigate whether demographic, socioeconomic, and reproductive health characteristics affect long-acting reversible contraceptive (LARC) use differently by race-ethnicity. Results may inform the dialogue on racial pressure and bias in LARC promotion.Data derived from the 2011-2013 and 2013-2015 National Surveys of Family Growth (NSFG). Our study sample included 9321 women (...) sample of women suggest similar patterns in LARC use by race-ethnicity.Results from this analysis of NSFG data do not provide evidence that observed differences in LARC use by race-ethnicity represent socioeconomic disparities, and may assuage some concerns about reproductive coercion among women of color. Nevertheless, it is absolutely critical that providers use patient-centered approaches for contraceptive counseling that promote women's autonomy in their reproductive health care decision

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2018 Contraception

36. Factors associated with initiating long-acting reversible contraception immediately after first trimester abortion. (PubMed)

Factors associated with initiating long-acting reversible contraception immediately after first trimester abortion. The objective was to identify predictors of postabortion long-acting reversible contraception (LARC) initiation to increase providers' understanding of motivators of contraceptive choices.We prospectively enrolled a cohort of women having abortions at <13 weeks' gestational age who were eligible to receive no-cost contraceptive methods immediately postprocedure (N=1662 (...) ) to evaluate the demographic and reproductive factors associated with choosing and receiving a long-acting contraceptive versus a short-acting method. We used stepwise logistic regression to identify independent predictors of LARC initiation.During the study period, 1072 (64.5%) chose an immediate postabortion LARC method and 590 (35.5%) chose another method. Compared to the group of women who chose a non-LARC method, women who chose a LARC method were more likely to have a surgical abortion and were

2018 Contraception

37. Use of Long-Acting Reversible Contraception by Obstetrics and Gynecology Residents: An Examination of Access for All Women. (PubMed)

Use of Long-Acting Reversible Contraception by Obstetrics and Gynecology Residents: An Examination of Access for All Women. Although long-acting reversible contraception (LARC) use is increasing in the general female population, only 12% of all women who use contraception and 4.8% of nulliparous women in the United States use either the intrauterine device (IUD) or contraceptive implant. In several studies, however, female physicians prefer LARC for contraception. In 2016, an anonymous (...) electronic survey was administered to all U.S. obstetrics and gynecology residents before the start of the annual in-training examination administered by the Council on Resident Education in Obstetrics and Gynecology. The survey included questions about LARC, including personal use. Fifty percent of female residents or the female partners of male residents used IUDs for contraception, 31.3% used combined oral contraceptives, and 3% used a contraceptive implant. Among nulliparous residents, 37.7% used

2018 Obstetrics and Gynecology

38. Use of Long-Acting Reversible Contraception Among Adolescent and Young Adult Women and Receipt of Sexually Transmitted Infection/Human Immunodeficiency Virus-Related Services. (PubMed)

Use of Long-Acting Reversible Contraception Among Adolescent and Young Adult Women and Receipt of Sexually Transmitted Infection/Human Immunodeficiency Virus-Related Services. Long-acting reversible contraceptive (LARC) methods do not require annual clinic visits for continuation, potentially impacting receipt of recommended sexually transmitted infection (STI)/human immunodeficiency virus (HIV) services for young women. We assess service receipt among new and continuing LARC users versus (...) moderately and less effective method users and non-contraceptors.Using 2011-2015 National Survey of Family Growth data from sexually active women aged 15-24 years (n = 2,018), we conducted logistic comparisons of chlamydia, any STI and HIV testing, and sexual risk assessment in the past year by current contraceptive type.Less than half of respondents were tested for chlamydia (40.9%), any STI (47.3%), or HIV (25.9%); 66.5% had their sexual risk assessed. Differences in service receipt between new

2018 The Journal of Adolescent Health

39. Changes in uptake and cost of long-acting reversible contraceptive devices following the introduction of a new low-cost levonorgestrel IUD in Utah's Title X clinics: A retrospective review. (PubMed)

Changes in uptake and cost of long-acting reversible contraceptive devices following the introduction of a new low-cost levonorgestrel IUD in Utah's Title X clinics: A retrospective review. The objective was to assess changes in long-acting reversible contraceptive (LARC) method uptake at Utah's Title X clinics before and after introduction of a new, low-cost levonorgestrel (LNG) 52mg IUD (Liletta®).We conducted a retrospective medical record review of LARC visits occurring at seven Title-X

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2018 Contraception

40. Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers (PubMed)

Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers This study aimed to describe the intentions of and barriers to the use of long-acting reversible contraceptives (LARCs) in the post-abortion period among women seeking abortion in mainland China.A cross-sectional study was conducted from July 2015 to December 2015 using a waiting room questionnaire. A total of 381 women seeking abortions were recruited

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2018 Reproductive health

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