California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision


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Abstract

OBJECTIVE:To assess the extent to which practices offering family planning services are able to offer intrauterine devices (IUDs) and implants in one visit and to identify the reasons why multiple visits may be required.METHODS:In the fall of 2011, 1,000 California family planning providers were asked about their long-acting reversible contraception delivery practices in a probability survey. We used multivariable logistic regression to examine practice characteristics associated with same-day provision of IUDs and implants.RESULTS:Among the 636 responding practices, 67% offered an IUD and 40% offered a contraceptive implant onsite. Among those with onsite provision, the majority required two or more visits to place an IUD (58%); almost half required two visits to place an implant (47%). Nearly all Planned Parenthood practices could place an IUD (95%) or implant (95%) at the initial visit, whereas the majority of all other practice types could not. The main reasons for delaying IUD and contraceptive implant provision included the need to screen and wait for test results (68% and 24%, respectively) and clinic flow and scheduling issues (50% and 64%, respectively). Multivariable analyses indicated that Planned Parenthood practices were significantly more likely than private practices to have same-day insertion protocols.CONCLUSION:Most of the family planning providers surveyed have not adopted same-day long-acting reversible contraception insertion protocols and face barriers to same-day provision.LEVEL OF EVIDENCE:III

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