Influences on Intentions to Place Long-Acting Reversible Contraceptives: A Pilot Study Comparing According to Provider Specialty in Ohio.

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.