Abstract
Study Objective
According to the American Academy of Pediatrics, pediatricians are to counsel and
provide long-acting reversible contraceptives (LARCs) as first line of defense contraceptives
because they are the most effective. We wanted to explore positive influences on LARC
placement for pediatricians, particularly compared with providers in other specialties
who care for women.
Design
Survey methods with data analyzed using analyses of variance and general linear models
in statistical software SPSS version 24.0 (IBM Corp).
Setting
Online survey.
Participants
Participants were 224 providers across the state of Ohio who specialize in family
medicine (51.8%), obstetrics/gynecology (17.9%), pediatrics (16.5%), and internal
medicine (13.8%). Most of the sample was female (50.9%) and Caucasian (74.6%). The
most frequent provider types were Doctors of Osteopathic Medicine (42.0%), followed
by Doctors of Medicine (37.9%), and Certified Nurse Practitioners (8.5%).
Interventions
None.
Main Outcome Measures
Attitudes about LARCs, perceived norms about placing LARCs, perceived behavioral control
over placing LARCs, intentions to place LARCs.
Results
Means for all of the variables (attitudes, perceived norms, perceived behavioral control,
and intentions to place) differed according to provider specialty. A pattern emerged
across these variables in which internal medicine and pediatric practitioners reported
lower attitudes, perceived norms, perceived behavioral control, and intentions to
place LARCs than family medicine and obstetrics/gynecology practitioners, in that
order.
Conclusion
To increase positive attitudes and perceived norms about LARCs, professional organizations
should increase communication to providers about the importance and expectations to
place, counsel about, and facilitate placement of LARCs, and medical schooling can
improve LARC counseling and procedural training to medical students, interns, and
residents. Because perceived behavioral control is linked to intentions to place LARCs,
perhaps providers would feel more confident to place them if they had more deliberate
training. For pediatricians in particular, perhaps encouraging those who do not currently
provide LARC methods to begin with training in implant placement would be a way to
capitalize on their more favorable attitudes about implants. For pediatricians who
do not feel comfortable providing device placement themselves, other strategies should
be encouraged to facilitate provision of LARCs.
Key Words
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Article info
Publication history
Published online: March 26, 2018
Footnotes
Dr Broecker has received honoraria from Merck and Co for being a Nexplanon trainer. The remaining authors indicate no conflicts of interest.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
