Abstract
Background
Despite the elevated rates of teen and unplanned pregnancies across the United States,
long-acting reversible contraceptives (LARCs) remain a less utilized birth control
method. The present study investigated family planning providers’ attitudes and considerations
when recommending family planning methods and LARCs to clients. Additionally, this
study explored whether urban–rural differences exist in providers’ attitudes toward
LARCs and in clients’ use of LARCs.
Methods
Data were collected using an online survey of family planning providers at Title X
clinics in Texas. Survey data was linked to family planning client data from the Family
Planning Annual Report (2008).
Results
Findings indicated that, although providers were aware of the advantages of LARCs,
clients’ LARC use remains infrequent. Providers reported that the benefits of hormone
implants include their effectiveness for 3 years and that they are an option for women
who cannot take estrogen-based birth control. Providers acknowledged the benefits
of several types of LARCs; however, urban providers were more likely to acknowledge
the benefits of hormone implants compared with their rural counterparts. Results also
indicated barriers to recommending LARCs, such as providers’ misinformation about
LARCs and their caution in recommending LARCs to adolescents. However, findings also
indicated providers lack training in LARC insertion, specifically among those practicing
in rural areas.
Conclusions
In light of the effectiveness and longevity of LARCs, teenagers and clients living
in rural areas are ideal LARC candidates. Increased training among family planning
providers, especially for those practicing in rural areas, may increase their recommendations
of LARCs to clients.
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Biography
Margaret L. Vaaler, PhD, is a Research Specialist at the Texas Department of State Health Services. Her research interests focus on the relationship between attitudes and health behaviors, patterns in help-seeking behavior, health disparities, and maternal and child health.
Biography
Lauri K. Kalanges, MD, MPH, is currently the Section Director and Medical Director for Health Promotion and Chronic Disease Prevention at the Texas Department of State Health Services.
Biography
Vincent P. Fonseca, MD, MPH, is the Director of Medical Informatics at Intellica Corporation and the co-founder of the Population Health Institute of Texas. His interests are improving the delivery of publicly funded health-related services and improving the health of defined populations.
Biography
Brian C. Castrucci, MA, is the Director of the Maternal and Child Health program at the Georgia Department of Community Health.
Article info
Publication history
Published online: January 24, 2012
Accepted:
November 21,
2011
Received in revised form:
November 16,
2011
Received:
June 2,
2011
Identification
Copyright
© 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
