| dc.description.abstract | Unplanned pregnancies have individual, familial, and societal consequences and continue to occur in the United States with over two million women experiencing an unplanned pregnancy each year (GI, 2016). Long-acting reversible contraceptives (LARCs) are highly effective methods yet underutilized within the United States. LARCs are considered a safe form of contraception that is not reliant upon the user for efficacy (Strasser et al., 2016). Provider interest, beliefs, knowledge, and training pose a significant barrier to LARC utilization (Shoupe, 2016). This practice improvement project aimed to understand the current knowledge and beliefs of healthcare providers as well as provide information about evidence-based contraceptive counseling and LARCs. Following collection of an online LARC questionnaire, the project intervention included design and implementation of an educational hands-on training session. The online LARC questionnaire was sent to healthcare providers across Minnesota and North Dakota with the goal to assess the provider’s knowledge, training, beliefs, and interests related to LARC utilization. The training session consisted of an educational presentation followed by insertion and removal training for one specific LARC method with nurse practitioners from across the region. A total of 166 individuals initiated the questionnaire and 147 responses were considered eligible for analysis. Results demonstrated providers in family medicine report less comfort providing LARC counseling than providers within the OB/GYN specialty. Fewer family medicine providers were trained to perform LARC insertion; consistent with findings in the review of literature. An assessment of the provider’s knowledge on recommending LARCs in females with coexisting conditions demonstrated uncertainty with current medical eligibility criteria published by the Center for Disease Control and Prevention. Tiered-effectiveness counseling is underutilized with only 18.6% reporting it as their primary contraceptive counseling method. The educational presentation had 14 participants in the audience; a total of eight participants completed the post-training evaluation questionnaire. Following the training, 100% of participants planned to utilize tiered-effectiveness counseling and insert LARCs in their practice. Knowledge gaps and barriers to LARC utilization continue to exist. Additional interventions targeting the provider and patient-linked barriers are needed to decrease unintended pregnancies in the United States. | en_US |
