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Long-Acting Reversible Contraception

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161. Understanding the low uptake of long-acting reversible contraception by young women in Australia: a qualitative study. (PubMed)

Understanding the low uptake of long-acting reversible contraception by young women in Australia: a qualitative study. Australia has high rates of teenage pregnancy compared with many Western countries. Long-acting reversible contraception (LARC) offers an effective method to help decrease unintended pregnancies; however, current uptake remains low. The aim of this study was to investigate barriers to LARC use by young women in Australia.Healthcare professionals were recruited through publicly (...) interviewed and four focus groups were conducted with 27 young women. Shared barriers identified included norms, misconceptions, bodily consequences, and LARC access issues. An additional barrier identified by young women was a perceived lack of control over hormones entering the body from LARC devices. Healthcare professionals also raised as a barrier limited confidence and support in LARC insertions. Strategies identified to increase contraceptive knowledge and access included increasing nurses' role

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2015 BMC Women's Health

162. Young Age, Nulliparity, and Continuation of Long-Acting Reversible Contraceptive Methods. (PubMed)

Young Age, Nulliparity, and Continuation of Long-Acting Reversible Contraceptive Methods. To assess the relationship among young age, nulliparity, and continuation of long-acting reversible contraceptive (LARC) methods.We performed a secondary analysis of the Contraceptive CHOICE Project database, an observational cohort study of 9,256 sexually active reproductive-aged females. This analysis focused on continuation of the intrauterine device and implant in nulliparous adolescent participants (...) compared with parous, older women. We analyzed our data by age-parity groups and individual characteristics and used multivariable analysis to assess the association of age and parity on continuation.There were 6,106 participants in our analytic set, including 863 aged 14-19 years. Long-acting reversible contraceptive continuation rates at 12 months were high and similar between all age-parity groups ranging from 82-86%. In the Cox proportional hazards model, nulliparous participants using the copper

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2015 Obstetrics and Gynecology

163. California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision. (PubMed)

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision. To assess the extent to which practices offering family planning services are able to offer intrauterine devices (IUDs) and implants in one visit and to identify the reasons why multiple visits may be required.In the fall of 2011, 1,000 California family planning providers were asked about their long-acting reversible contraception delivery practices in a probability survey (...) -day long-acting reversible contraception insertion protocols and face barriers to same-day provision.III.

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2015 Obstetrics and Gynecology

164. Immediate postpartum provision of long-acting reversible contraception. (PubMed)

Immediate postpartum provision of long-acting reversible contraception. The objective of this review is to describe current literature regarding the role and characteristics of long-acting reversible contraception (LARC) used immediately postpartum.Copper and levonorgestrel intrauterine devices (IUDs) inserted immediately postpartum at the time of both vaginal and cesarean deliveries are associated with higher rates of continuation at 6-12 months when compared with IUDs placed at the postpartum (...) visit (4-8 weeks after delivery), despite higher rates of expulsion. IUDs and contraceptive implants are cost-effective when used immediately postpartum, and they are associated with longer interpregnancy intervals. There is limited evidence regarding the effects of immediate postpartum LARC on breastfeeding.Use of LARC methods in the immediate postpartum period is both effective and safe, and could reduce unmet need for contraception during this time. More research is needed to explore various

2015 Current Opinion in Obstetrics and Gynecology

165. Comparison of uptake of long-acting reversible contraception after abortion from a hospital or a community sexual and reproductive healthcare setting: an observational study. (PubMed)

Comparison of uptake of long-acting reversible contraception after abortion from a hospital or a community sexual and reproductive healthcare setting: an observational study. Uptake of the most effective long-acting reversible methods of contraception (LARC) immediately after abortion has been shown to reduce a woman's risk of further abortion. We aimed to compare the uptake of LARC at abortion services from a hospital department of obstetrics and gynaecology and a specialist contraceptive (...) interval (CI) 0.47-0.53%] compared to those attending the hospital site (39.2%; 95% CI 0.36-0.42%; p<0.0001). Amongst women having an outpatient early medical abortion, LARC uptake at the SRH was twice that of the hospital setting (48.4% vs 23.3%; p<0.0001).Higher uptake of immediate post-abortal LARC was observed amongst women who were assessed at the specialist contraceptive service in the community SRH setting compared to the hospital setting. Further research is required to determine the reasons

2015 Journal of Family Planning and Reproductive Health Care

166. Long-acting reversible contraception: Who, what, when, and how. (PubMed)

Long-acting reversible contraception: Who, what, when, and how. This review provides practical tips--and dispels some common misconceptions--about these devices, which have higher rates of patient satisfaction and lower rates of failure than any other reversible contraceptives..

2015 Journal of Family Practice

167. Changes in Use of Long-Acting Reversible Contraceptive Methods Among U.S. Women, 2009-2012. (PubMed)

Changes in Use of Long-Acting Reversible Contraceptive Methods Among U.S. Women, 2009-2012. To examine current levels, current correlates of, and changes in long-acting reversible contraceptive (LARC) use, including intrauterine devices and implants, among females aged 15-44 years using contraception between 2008-2010 and 2011-2013 with specific attention to associations between race, income, and age and their LARC use.We analyzed data from two rounds of the National Survey of Family Growth (...) , nationally representative samples of females aged 15-44 years, consisting of 6,428 females in 2008-2010 and 5,601 females in 2011-2013. We conducted simple and multivariable logistic regression analyses with adjustments for the sampling design to identify demographic characteristics predictive of LARC use and changes in these patterns between the two time periods. In this cross-sectional, descriptive study, our primary outcome of interest was current prevalence of LARC use among all contraceptive users

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2015 Obstetrics and Gynecology

168. Projections and Opinions from One Hundred Experts in Long Acting Reversible Contraception. (PubMed)

Projections and Opinions from One Hundred Experts in Long Acting Reversible Contraception. This survey of published researchers of long-acting reversible contraceptives (LARCs) examines their opinions about important barriers to LARC use in the United States (US), projections for LARC use in the absence of barriers and attitudes toward incentives for clinicians to provide and women to use LARC methods.We identified 182 authors of 59 peer-reviewed papers on LARC use published since 2013. A total (...) in the absence of these barriers were 25-29% of contracepting women. There was limited support for provider incentives and almost no support for incentives for women to use LARC methods, primarily out of concern about coercion.Clinical and social science LARC experts project at least a doubling of the current US rate of LARC use if barriers to method provision and adoption are removed. While LARC experts recognize the promise of LARC methods to better meet women's contraceptive needs, they anticipate

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2015 Contraception

169. The Cost of Unintended Pregnancies (CoUP) in Canada: Estimating Direct Cost, Role of Imperfect Adherence, and the Potential Impact of Increased Use of Long-Acting Reversible Contraceptives (PubMed)

The Cost of Unintended Pregnancies (CoUP) in Canada: Estimating Direct Cost, Role of Imperfect Adherence, and the Potential Impact of Increased Use of Long-Acting Reversible Contraceptives Unintended pregnancies (UPs) are associated with a significant cost burden, but the full cost burden in Canada is not known. The objectives of this study were to quantify the direct cost of UPs in Canada, the proportion of cost attributable to UPs and imperfect contraceptive adherence and the potential cost (...) savings with increased uptake of long-acting reversible contraceptives (LARCs).A cost model was constructed to estimate the annual number and direct costs of UP in women aged 18 to 44 years. Adherence-associated UP rates were estimated using perfect- and typical-use contraceptive failure rates. Change in annual number of UPs and impact on cost burden were projected in three scenarios of increased LARC usage. One-way sensitivity analyses were conducted to assess the impact of key variables on scenarios

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2015 Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC

170. Internet-Based Information on Long-Acting Reversible Contraception for Adolescents (PubMed)

Internet-Based Information on Long-Acting Reversible Contraception for Adolescents Long-acting reversible contraception (LARC) is safe, effective, and recommended as first-line contraception for adolescents. Despite clear medical recommendations, the type and quality of Internet information regarding LARC for teenagers is unknown.Data were collected through web queries. Resulting websites were assessed for quality criteria and a priori content themes based on the leading medical societies

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2015 Journal of primary care & community health

171. The Relationship between Long Acting Reversible Contraception and Insurance Coverage: A Retrospective Analysis. (PubMed)

The Relationship between Long Acting Reversible Contraception and Insurance Coverage: A Retrospective Analysis. The objective was to determine if there is a relationship between patients' financial responsibility (out-of-pocket expenses) and placement of long-acting, reversible contraceptive (LARC) methods among girls and women living in Appalachia who expressed interest in LARC device placement.A retrospective chart analysis of patients prescribed an intrauterine device (IUD (...) -of-pocket expenses over $200. Despite the improvements in coverage for many women provided under the Affordable Care Act, cost may remain a barrier for privately insured women who are required to pay some or all of the cost of LARC methods.Unintended pregnancy rates in the United States remain high, especially in Appalachia. One contributing factor is reliance on user-dependent methods which have significantly high typical use failure rates. Placement of LARC methods for more patients could decrease

2015 Contraception

172. Source of care and variation in long-acting reversible contraception use. (PubMed)

Source of care and variation in long-acting reversible contraception use. To examine variation in long acting reversible contraception (LARC) use by source of birth control services.Cross-sectional study.Not applicable.Sexually active women who received contraceptive services in the past 12 months, who were neither pregnant nor trying to become pregnant and who were not sterilized and nor were their partners sterilized.Three multinomial logistic regression models assessed the relationship

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2015 Fertility and Sterility

173. Use of long-acting reversible contraceptives to reduce the rate of teen pregnancy. (PubMed)

Use of long-acting reversible contraceptives to reduce the rate of teen pregnancy. Long-acting reversible contraceptives (LARCs) are safe for use in adolescents and do not rely on compliance or adherence for effectiveness. Continuation rates are higher and pregnancy rates are lower for adolescent users of LARCs compared with short-acting methods such as oral contraceptives. Similarly, repeat pregnancy rates are lower when LARCs are used compared with other forms of contraception. Myths (...) and misconceptions about LARCs and other contraceptives remain a barrier to their use. Health care providers are in a unique position to provide confidential care to adolescents, and should provide education to them about the various contraceptive options, especially LARCs. Copyright © 2015 Cleveland Clinic.

2015 Cleveland Clinic Journal of Medicine

174. Realizing Reproductive Health Equity Needs More Than Long-Acting Reversible Contraception (LARC). (PubMed)

Realizing Reproductive Health Equity Needs More Than Long-Acting Reversible Contraception (LARC). 26562116 2016 04 13 2018 12 02 1541-0048 106 1 2016 Jan American journal of public health Am J Public Health Realizing Reproductive Health Equity Needs More Than Long-Acting Reversible Contraception (LARC). 18-9 10.2105/AJPH.2015.302900 Gubrium Aline C AC Aline C. Gubrium is with the Department of Health Promotion and Policy, University of Massachusetts, Amherst. Emily S. Mann

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2015 American Journal of Public Health

175. Postabortion Initiation of Long-Acting Reversible Contraception by Adolescent and Nulliparous Women in New Zealand. (PubMed)

Postabortion Initiation of Long-Acting Reversible Contraception by Adolescent and Nulliparous Women in New Zealand. To describe changes in receipt of immediate postabortion long-acting reversible contraception (LARC) by adolescent and nulliparous women in New Zealand.Nationally collected data on immediate postabortion receipt of an intrauterine method (intrauterine device [IUD]/intrauterine system [IUS]) or contraceptive implant were analyzed to describe proportions and demographic

2015 The Journal of Adolescent Health

176. Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation. (PubMed)

Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation. The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners.We conducted 14 (...) and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC

2015 The Journal of Adolescent Health

177. Comparing effectiveness of two client follow-up approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) among the underserved in rural Punjab, Pakistan: a study protocol and participants’ profile (PubMed)

Comparing effectiveness of two client follow-up approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) among the underserved in rural Punjab, Pakistan: a study protocol and participants’ profile Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced (...) by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC

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2015 Reproductive health

178. Post-abortion initiation of long-acting reversible contraception in New Zealand. (PubMed)

Post-abortion initiation of long-acting reversible contraception in New Zealand. Post-abortion initiation of long-acting reversible contraception (LARC) reduces subsequent abortion rates within 24 months, but the prevalence of post-abortion LARC use in New Zealand is unknown.To describe post-abortion initiation of intrauterine and implantable LARC methods in New Zealand between 2007 and 2012, and to determine what impact the introduction of government-funded (free) levonorgestrel (LNG) implants

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2015 Journal of Family Planning and Reproductive Health Care

179. Long-acting reversible contraception in the pediatric emergency department: clinical implications and common challenges. (PubMed)

Long-acting reversible contraception in the pediatric emergency department: clinical implications and common challenges. Long-acting reversible contraception (LARC) is recommended as first-line contraception for adolescents and young adults. As the use of LARC increases, pediatric emergency medicine clinicians should be able to recognize different types of LARC and address their common adverse effects, adverse reactions, and complications. This continuing medical education activity provides

2015 Pediatric Emergency Care

180. Effectiveness of long-acting reversible contraception. (PubMed)

Effectiveness of long-acting reversible contraception. The rate of unintended pregnancy in the United States is much higher than in other developed nations. Approximately half of unintended pregnancies are due to contraceptive failure, largely owing to inconsistent or incorrect use.We designed a large prospective cohort study to promote the use of long-acting reversible contraceptive methods as a means of reducing unintended pregnancies in our region. Participants were provided with reversible (...) contraception of their choice at no cost. We compared the rate of failure of long-acting reversible contraception (intrauterine devices [IUDs] and implants) with other commonly prescribed contraceptive methods (oral contraceptive pills, transdermal patch, contraceptive vaginal ring, and depot medroxyprogesterone acetate [DMPA] injection) in the overall cohort and in groups stratified according to age (less than 21 years of age vs. 21 years or older).Among the 7486 participants included in this analysis, we

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2012 NEJM

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