Long-acting Reversible Contraceptives for Adolescents

Unintended pregnancy in adolescents remains a public health problem in the U.S. even during a global pandemic; as 64% of pregnancies in 20-24 year olds, 77% in 18-19 year olds and 90% in 15-17 year olds are unintended and/or unplanned.

LARCs as first-line contraceptives

Teen pregnancy correlates with lower lifetime educational and economic achievement and a high likelihood of early parenting of their own offspring. Long-acting reversible contraceptives (LARCs) are recommended as the first-line, most effective contraceptive option according to the U.S. Centers for Disease Control and Prevention1 and the World Health Organization.2 Pediatricians often feel ill-equipped to counsel youth adequately on all options, and same-day LARC access can be a challenge. Thanks to a $645,753 grant from Merck, Ellen Rome, MD, MPH, will be doing research to create a toolkit usable by primary care clinicians to decrease unintended teen/young adult pregnancies through greater LARC use with easier access.

Dr. Rome and collaborators will use an evidence-based implementation framework to conduct interviews with pediatric practices that currently offer high-volume LARC services to identify the processes necessary for scaling up LARC delivery, including staffing needs, essential training on insertion/removal, billing, contracts, stocking and supply chain. This toolkit can then be used to scale up care locally and nationally.

References

1. Centers for Disease Control and Prevention. Contraception. https://www.cdc.gov/reproductivehealth/contraception/index.htm#Contraceptive-Effectiveness. Updated August 13, 2020. Retrieved August 25, 2020.
2. World Health Organization. Family planning/contraception methods. https://www.who.int/en/news-room/fact-sheets/detail/family-planning-contraception. Updated June 22, 2020. Retrieved August 25, 2020.