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Long-Acting Reversible Contraception

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61. Contraceptive services for under 25s

are given advice and information on all types of contraception. This includes additional tailored support to meet the particular needs and choices of those who are socially disadvantaged or who may find it difficult to use these services. NICE has also produced guidelines on long-acting reversible contraception, looked after children and preventing sexually transmitted infections and under 18 conceptions. Who is it for? Commissioners, managers and practitioners who have a direct or indirect role (...) , NICE guidance on: long-acting reversible contraception, looked after children and preventing sexually transmitted infections and under 18 conceptions (for further details, see section 7). Contraceptive services for under 25s (PH51) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 7 of 681 1 Recommendations Recommendations The evidence statements underpinning the recommendations are listed in appendix C

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

62. The ethics of State-sponsored and clinical promotion of long-acting reversible contraception

The ethics of State-sponsored and clinical promotion of long-acting reversible contraception The ethics of State-sponsored and clinical promotion of long-acting reversible contraception | Journal of Medical Ethics blog by Originally published in the . By Jeffrey Wale and Sam Rowlands. Global responses to the Covid-19 pandemic offer a good opportunity to re-examine the role of State actors (policymakers, regulatory bodies, clinical commissioning groups, service providers) and healthcare (...) professionals in the promotion of health-related behaviours. Just how far should healthcare professionals go in promoting, persuading, and influencing ‘good’ behaviours in the patient encounter? Who decides what is ‘good’ and how far should resource considerations shape the informational exchange process and the recommendations made to individual patients? uses long-acting reversible contraception (LARC) as the fulcrum to address these issues. There has been a tendency for the public and clinical narrative

2020 Journal of Medical Ethics blog

63. The ethics of State-sponsored and clinical promotion of long-acting reversible contraception

The ethics of State-sponsored and clinical promotion of long-acting reversible contraception The ethics of State-sponsored and clinical promotion of long-acting reversible contraception | BMJ Sexual & Reproductive Health blog by By Dr Jeffrey Wale & Professor Sam Rowlands, Global responses to the Covid-19 pandemic offer a good opportunity to re-examine the role of State actors (policymakers, regulatory bodies, clinical commissioning groups, service providers) and healthcare professionals (...) in the promotion of health-related behaviours. Just how far should healthcare professionals go in promoting, persuading, and influencing ‘good’ behaviours in the patient encounter? Who decides what is ‘good’ and how far should resource considerations shape the informational exchange process and the recommendations made to individual patients? Our article uses long-acting reversible contraception (LARC) as the fulcrum to address these issues. There has been a tendency for the public and clinical narrative

2020 Journal of Family Planning and Reproductive Health Care blog

64. The history of tiered-effectiveness contraceptive counseling and the importance of patient-centered family planning care. Full Text available with Trip Pro

The history of tiered-effectiveness contraceptive counseling and the importance of patient-centered family planning care. Public health workers, clinicians, and researchers have tried to increase long-acting reversible contraceptive (LARC) use by changing contraceptive counseling between patients and providers. Several major health organizations now recommend tiered-effectiveness counseling, in which the most effective methods are explained first so that patients can use information about (...) the relative efficacy of contraceptive methods to make an informed choice. Some scholars and practitioners have raised concerns that, given histories of inequitable treatment and coercion in reproductive health care, tiered-effectiveness counseling may undermine patient autonomy and choice. This Clinical Opinion examines the development of tiered-effectiveness contraceptive counseling, how its rise mirrored the focus on promoting LARC to decrease the unintended pregnancy rate, and key considerations

2020 American Journal of Obstetrics and Gynecology

65. Higher contraceptive uptake in HIV treatment centers offering integrated family planning services: A national survey in Kenya. (Abstract)

throughout Kenya. The majority (73%) of facilities offered integrated FP services. They were more likely to be offered in public than private facilities (Prevalence Ratio [PR]: 1.86, 95% Confidence Interval [CI]: 1.11-3.11; p = 0.02] and were more common in the Nyanza region than the Nairobi region (77% vs 35% respectively, p = 0.06). Any contraceptive use (89% vs 80%), use of modern contraception (88% vs 80%), dual method use (40% vs 30%), long-acting reversible contraception (LARC) (28% vs 20 (...) %), and non-barrier short-term methods (34% vs 27%) were all significantly higher in facilities with integrated FP services (p < 0.001).The majority of high volume facilities integrated FP services into HIV care. Integrating FP services may increase modern contraceptive use among WLWH.Integration of FP services was associated with higher modern contraceptive use, lower unmet need for modern methods and higher use of long-acting, reversible contraception (LARC), and non-barrier short-term methods among

2020 Contraception

66. Theory-based interventions for contraception. Full Text available with Trip Pro

often reported effective contraception use at nine months (OR 2.04, 95% CI 1.47 to 2.83). In two studies, the MI group was less likely to report using ineffective contraception at three months (OR 0.31, 95% CI 0.12 to 0.77) and four months (OR 0.56, 95% CI 0.31 to 0.98), respectively. In the fourth trial, the MI group was more likely than a group with non-standard counseling to initiate long-acting reversible contraception (LARC) by one month (OR 3.99, 95% CI 1.36 to 11.68) and to report using LARC (...) Theory-based interventions for contraception. The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, many educational interventions addressing contraception have no explicit theoretical base.To review randomized controlled trials (RCTs) that tested

2016 Cochrane

67. Use of long-acting reversible contraception in a cluster-random sample of female sex workers in Kenya. Full Text available with Trip Pro

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 (...) attitude to and better knowledge of family planning, younger age, and lower education. High rates of adverse effects were reported for all methods.The findings suggest that implant use has increased among FSWs in Kenya. Unintended pregnancy risks remain high and IUD use is negligible. Although LARC rates are encouraging, further intervention is required to improve both uptake (particularly of IUDs) and greater access to family planning services.© 2019 The Authors. International Journal of Gynecology

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

68. Predictors of Discontinuation of Long-Acting Reversible Contraception Before 30 Months of Use by Adolescents and Young Women. Full Text available with Trip Pro

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

69. Implementing best practices for the provision of long-acting reversible contraception: a survey of obstetrician-gynecologists. Full Text available with Trip Pro

Implementing best practices for the provision of long-acting reversible contraception: a survey of obstetrician-gynecologists. To examine obstetrician-gynecologists' practices regarding provision of long-acting reversible contraceptive (LARC) methods same-day, immediately postpartum, or to women under age 21.Between August 2016 and March 2017, the American College of Obstetricians and Gynecologists (ACOG) sent 2500 of their members an electronic survey questionnaire regarding the provision

2019 Contraception

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

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 (...) and safety of LARC. We randomized all zip codes in a three-state study area to either a control group or a treatment group. Female Facebook users age 18-34 living in treated clusters received advertisements developed by the researchers in partnership with Planned Parenthood of Northern New England (PPNNE), which sponsored the campaign. We assessed changes in the number and rate of LARC insertions at PPNNE health centers by patients' treatment status.Facebook showed 1.8 million advertisements to women

2019 Contraception Controlled trial quality: uncertain

71. Patients' experiences with South Carolina's immediate postpartum Long-acting reversible contraception Medicaid policy. (Abstract)

Patients' experiences with South Carolina's immediate postpartum Long-acting reversible contraception Medicaid policy. We sought to examine women's experiences with immediate postpartum LARC counseling and use in the context of South Carolina's Medicaid policy.In 2016-18, we conducted semi-structured individual interviews with 25 women, ages 18-35, who gave birth within 2 years of the interview in South Carolina while insured by Medicaid and received contraceptive counseling about immediate (...) postpartum LARC during their pregnancies. We analyzed the interviews using a combination of deductive and inductive coding approaches.Participants were counseled on immediate postpartum LARC during prenatal care (n=23) and/or while in the hospital for childbirth (n=16). Some expressed dissatisfaction with providers' approaches to contraceptive counseling because they either did not receive enough information to make a fully informed decision or felt they were being pressured to use LARC. Among those who

2019 Contraception

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

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

73. Long-acting reversible contraception knowledge, attitudes, and use among HIV-infected and uninfected women and their providers. (Abstract)

Long-acting reversible contraception knowledge, attitudes, and use among HIV-infected and uninfected women and their providers. To describe differences in contraceptive knowledge, attitudes and use among HIV-infected and HIV-uninfected women served by an academic medical center in New York City, and to describe gaps in knowledge and practice of gynecologic (GYN) and HIV clinicians providing care at the same clinic sites where patients completed surveys.We conducted a survey comparing (...) contraceptive knowledge, attitudes, reproductive histories and long acting reversible contraception (LARC) use in HIV-infected and uninfected women. We also conducted a survey to elicit clinician demographic characteristics and education, contraceptive practice patterns and their knowledge of current contraceptive guidelines. We surveyed clinicians and patients at five ambulatory sites.We screened 90% of patients approached. All 257 women who were eligible completed a survey. These included 107 (42%) HIV

2019 Contraception

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

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

75. 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. (Abstract)

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

76. Factors Associated with Postpartum Use of Long-Acting Reversible Contraception. (Abstract)

Factors Associated with Postpartum Use of Long-Acting Reversible Contraception. Contraception use among postpartum women is important to prevent unintended pregnancies and optimize birth spacing. Long-acting reversible contraception, including intrauterine devices and implants, is highly effective, yet compared to less effective methods utilization rates are low.We sought to estimate prevalence of long-acting reversible contraception use among postpartum women and examine factors associated (...) with long-acting reversible contraception use among those using any reversible contraception.We analyzed 2012-2015 data from the Pregnancy Risk Assessment Monitoring System, a population-based survey among women with recent live births. We included data from 37 sites that achieved the minimum overall response rate threshold for data release. We estimated the prevalence of long-acting reversible contraception use in our sample (n = 143,335). We examined maternal factors associated with long-acting

2019 American Journal of Obstetrics and Gynecology

77. Effect of Staff Training and Cost Support on Provision of Long-Acting Reversible Contraception in Community Health Centers. Full Text available with Trip Pro

Effect of Staff Training and Cost Support on Provision of Long-Acting Reversible Contraception in Community Health Centers. To compare the proportion of women receiving same-day long-acting reversible contraception (LARC) between two different models of contraceptive provision adapted from the Contraceptive CHOICE Project.We used a controlled time-trend study design to compare 502 women receiving structured contraceptive counseling in addition to usual care ("Enhanced Care") to 506 women (...) a same-day insertion, 53.8% vs. 13.7% (RRadj 4.73; 95%CI 3.20-6.98) compared to "Enhanced Care."A contraceptive care model that included healthcare provider education and cost support for LARC in addition to structured contraceptive counseling resulted in higher rates of same-day LARC insertion compared to contraceptive counseling and usual care alone.Contraceptive care provision which includes contraceptive counseling, healthcare provider education, and "on-the-shelf", long-acting reversible

2019 Contraception

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

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

79. Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey. Full Text available with Trip Pro

Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey. In Mozambique, both the government and partners have undertaken efforts over the last decade to improve FP (family planning) services, especially through training health care providers and promoting the uptake of LARCs (Long Acting Reversible Contraceptives). Despite this, uptake of FP methods has not increased significantly. This study aims to examine (...) women's knowledge on LARCs, including their main sources of information, and the quality of care of FP services in rural areas.We conducted a repeated cross-sectional study, interviewing 417 women leaving FP consultations in 15 health facilities in Maputo Province, Mozambique. The main quality outputs measured were: 1)discussed, preferred and received contraceptive methods, 2)information received on usage and side-effects, 3)client-provider interaction, 4)being informed about the need for a follow-up

2018 BMC Women's Health

80. Abortion history and its association with current use of modern contraceptive methods in Luanda, Angola Full Text available with Trip Pro

a modern contraceptive method. The clear majority of the respondents (73.21%), regardless of abortion history, were using either no method, a traditional method, or condoms. Long-acting reversible contraceptive use was very low across all respondents (2.73%). The most common family planning method reported by women with a history of abortion was condoms (32.76%). Regression analysis demonstrated that women who had a history of abortion were 1.23 times more likely to use a modern contraceptive method (...) Abortion history and its association with current use of modern contraceptive methods in Luanda, Angola Women in sub-Saharan Africa often use abortion as a method of limiting their fertility and spacing births. However, it is not well understood whether having an abortion influences contraceptive behavior. The goal of this study was to examine associations between abortion history and use of a modern contraceptive method among women in Luanda, Angola.We analyzed data on 1,176 women aged 15-49

2018 Open access journal of contraception

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