Cluster, Randomized Trial on Long Acting Reversible Contraception (LARC) Education and Training

NCT ID: NCT01360216

Last Updated: 2020-07-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-05-31

Study Completion Date

2013-08-31

Brief Summary

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The purpose of the study is to measure whether an education and training intervention for clinicians and contraceptive counselors on long-acting reversible contraception (LARC) will result in greater use of the methods among contraceptive patients.

Detailed Description

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Unintended pregnancy is extremely high in the United States among young women, and use of contraceptives with top-tier effectiveness, intrauterine contraception and implants, is low. Contraceptive providers in the US have low knowledge of current scientific evidence on LARC methods, and do not routinely include these methods in counseling patients at highest risk of unintended pregnancy. This intervention provides evidence-based education and hands-on training to clinicians and contraceptive educators in Planned Parenthood affiliated Title X clinics throughout the US on LARC methods.

Conditions

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Contraception Behavior

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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LARC education and training

Clinicians and contraceptive educators practicing in clinics assigned to this arm receive a special half-day Continuing Medical Education (CME/CEU) accredited LARC education and training session.

Group Type EXPERIMENTAL

LARC education and training

Intervention Type BEHAVIORAL

A CME/CEU accredited Grand Rounds education and training session will be given to clinicians and contraceptive educators practicing in clinics assigned to the intervention arm. Clinicians will have hands-on training as well. The half-day session emphasizes evidence-based contraceptive counseling and provision.

Standard practice- control

Clinicians and contraceptive educators practicing in clinics assigned to this arm do not receive special LARC training and education session. Standard practice will be followed at clinics assigned to the control arm.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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LARC education and training

A CME/CEU accredited Grand Rounds education and training session will be given to clinicians and contraceptive educators practicing in clinics assigned to the intervention arm. Clinicians will have hands-on training as well. The half-day session emphasizes evidence-based contraceptive counseling and provision.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

This study involves two groups of human subjects: patients and staff at participating Planned Parenthood (PP) clinics in the United States.

Patient participants are young women receiving contraceptive counseling at Planned Parenthood clinics and staff participants are the clinicians and health educators serving these women.

Patients must be:

Female;

* Age 18-25;
* Fluent in English or Spanish;
* Not wanting to become pregnant in the next 12 months;
* Sexually active in past 3 months;
* At risk of pregnancy;
* Received contraceptive counseling;
* Not pregnant;
* Willing to be contacted by telephone over the next 12 months.

Clinic staff must be:

* Employed by a participating PP clinic; and
* Offer clinical care, counseling or education for abortion or contraception at the clinic. (This may include physicians, advance practice clinicians, nurses, social workers and health educators.)

For clinics to be eligible to be study sites, they must:

* Not share staff
* Have no active LARC interventions ongoing
* Have \>400 clients/year
Minimum Eligible Age

18 Years

Maximum Eligible Age

25 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Planned Parenthood Federation of America

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cynthia C Harper, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California San Francisco School of Medicine

J. Joseph Speidel, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

University of California San Francisco School of Medicine

Locations

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University of California San Francisco

San Francisco, California, United States

Site Status

Countries

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United States

References

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Thompson KM, Speidel JJ, Saporta V, Waxman NJ, Harper CC. Contraceptive policies affect post-abortion provision of long-acting reversible contraception. Contraception. 2011 Jan;83(1):41-7. doi: 10.1016/j.contraception.2010.06.008. Epub 2010 Sep 20.

Reference Type BACKGROUND
PMID: 21134502 (View on PubMed)

Harper CC, Blum M, de Bocanegra HT, Darney PD, Speidel JJ, Policar M, Drey EA. Challenges in translating evidence to practice: the provision of intrauterine contraception. Obstet Gynecol. 2008 Jun;111(6):1359-69. doi: 10.1097/AOG.0b013e318173fd83.

Reference Type BACKGROUND
PMID: 18515520 (View on PubMed)

Speidel JJ, Harper CC, Shields WC. The potential of long-acting reversible contraception to decrease unintended pregnancy. Contraception. 2008 Sep;78(3):197-200. doi: 10.1016/j.contraception.2008.06.001. Epub 2008 Jul 9. No abstract available.

Reference Type BACKGROUND
PMID: 18692608 (View on PubMed)

Goodman S, Hendlish SK, Reeves MF, Foster-Rosales A. Impact of immediate postabortal insertion of intrauterine contraception on repeat abortion. Contraception. 2008 Aug;78(2):143-8. doi: 10.1016/j.contraception.2008.03.003. Epub 2008 May 14.

Reference Type BACKGROUND
PMID: 18672116 (View on PubMed)

Goodman S, Hendlish SK, Benedict C, Reeves MF, Pera-Floyd M, Foster-Rosales A. Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion. Contraception. 2008 Aug;78(2):136-42. doi: 10.1016/j.contraception.2008.03.008. Epub 2008 Jun 18.

Reference Type BACKGROUND
PMID: 18672115 (View on PubMed)

Kavanaugh ML, Jones RK, Finer LB. How commonly do US abortion clinics offer contraceptive services? Contraception. 2010 Oct;82(4):331-6. doi: 10.1016/j.contraception.2010.04.010. Epub 2010 May 21.

Reference Type BACKGROUND
PMID: 20851226 (View on PubMed)

Kavanaugh ML, Jones RK, Finer LB. Perceived and insurance-related barriers to the provision of contraceptive services in U.S. abortion care settings. Womens Health Issues. 2011 May-Jun;21(3 Suppl):S26-31. doi: 10.1016/j.whi.2011.01.009.

Reference Type BACKGROUND
PMID: 21530835 (View on PubMed)

Stanwood NL, Bradley KA. Young pregnant women's knowledge of modern intrauterine devices. Obstet Gynecol. 2006 Dec;108(6):1417-22. doi: 10.1097/01.AOG.0000245447.56585.a0.

Reference Type BACKGROUND
PMID: 17138775 (View on PubMed)

Hladky KJ, Allsworth JE, Madden T, Secura GM, Peipert JF. Women's knowledge about intrauterine contraception. Obstet Gynecol. 2011 Jan;117(1):48-54. doi: 10.1097/AOG.0b013e318202b4c9.

Reference Type BACKGROUND
PMID: 21173643 (View on PubMed)

Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010 Aug;203(2):115.e1-7. doi: 10.1016/j.ajog.2010.04.017. Epub 2010 Jun 11.

Reference Type BACKGROUND
PMID: 20541171 (View on PubMed)

Madden T, Allsworth JE, Hladky KJ, Secura GM, Peipert JF. Intrauterine contraception in Saint Louis: a survey of obstetrician and gynecologists' knowledge and attitudes. Contraception. 2010 Feb;81(2):112-6. doi: 10.1016/j.contraception.2009.08.002. Epub 2009 Sep 16.

Reference Type BACKGROUND
PMID: 20103447 (View on PubMed)

Kittur ND, Secura GM, Peipert JF, Madden T, Finer LB, Allsworth JE. Comparison of contraceptive use between the Contraceptive CHOICE Project and state and national data. Contraception. 2011 May;83(5):479-85. doi: 10.1016/j.contraception.2010.10.001. Epub 2010 Nov 23.

Reference Type BACKGROUND
PMID: 21477693 (View on PubMed)

Fleming KL, Sokoloff A, Raine TR. Attitudes and beliefs about the intrauterine device among teenagers and young women. Contraception. 2010 Aug;82(2):178-82. doi: 10.1016/j.contraception.2010.02.020. Epub 2010 Apr 13.

Reference Type BACKGROUND
PMID: 20654760 (View on PubMed)

Darney P, Patel A, Rosen K, Shapiro LS, Kaunitz AM. Safety and efficacy of a single-rod etonogestrel implant (Implanon): results from 11 international clinical trials. Fertil Steril. 2009 May;91(5):1646-53. doi: 10.1016/j.fertnstert.2008.02.140. Epub 2008 Apr 18.

Reference Type BACKGROUND
PMID: 18423453 (View on PubMed)

Raine TR, Foster-Rosales A, Upadhyay UD, Boyer CB, Brown BA, Sokoloff A, Harper CC. One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives. Obstet Gynecol. 2011 Feb;117(2 Pt 1):363-371. doi: 10.1097/AOG.0b013e31820563d3.

Reference Type BACKGROUND
PMID: 21252751 (View on PubMed)

Shelton JD. Risk of clinical pelvic inflammatory disease attributable to an intrauterine device. Lancet. 2001 Feb 10;357(9254):443. doi: 10.1016/S0140-6736(00)04012-5.

Reference Type BACKGROUND
PMID: 11273068 (View on PubMed)

Grimes DA, Lopez LM, Schulz KF, Stanwood NL. Immediate postabortal insertion of intrauterine devices. Cochrane Database Syst Rev. 2010 Jun 16;(6):CD001777. doi: 10.1002/14651858.CD001777.pub3.

Reference Type BACKGROUND
PMID: 20556754 (View on PubMed)

Allen RH, Goldberg AB, Grimes DA. Expanding access to intrauterine contraception. Am J Obstet Gynecol. 2009 Nov;201(5):456.e1-5. doi: 10.1016/j.ajog.2009.04.027. Epub 2009 Jun 13.

Reference Type BACKGROUND
PMID: 19527902 (View on PubMed)

Deans EI, Grimes DA. Intrauterine devices for adolescents: a systematic review. Contraception. 2009 Jun;79(6):418-23. doi: 10.1016/j.contraception.2008.12.009. Epub 2009 Feb 7.

Reference Type BACKGROUND
PMID: 19442775 (View on PubMed)

Grimes DA. Intrauterine device and upper-genital-tract infection. Lancet. 2000 Sep 16;356(9234):1013-9. doi: 10.1016/S0140-6736(00)02699-4.

Reference Type BACKGROUND
PMID: 11041414 (View on PubMed)

Stanwood NL, Garrett JM, Konrad TR. Obstetrician-gynecologists and the intrauterine device: a survey of attitudes and practice. Obstet Gynecol. 2002 Feb;99(2):275-80. doi: 10.1016/s0029-7844(01)01726-4.

Reference Type BACKGROUND
PMID: 11814509 (View on PubMed)

Postlethwaite D, Shaber R, Mancuso V, Flores J, Armstrong MA. Intrauterine contraception: evaluation of clinician practice patterns in Kaiser Permanente Northern California. Contraception. 2007 Mar;75(3):177-84. doi: 10.1016/j.contraception.2006.10.010. Epub 2007 Jan 16.

Reference Type BACKGROUND
PMID: 17303486 (View on PubMed)

Hubacher D, Vilchez R, Gmach R, Jarquin C, Medrano J, Gadea A, Grey T, Pierre-Louis B. The impact of clinician education on IUD uptake, knowledge and attitudes: results of a randomized trial. Contraception. 2006 Jun;73(6):628-33. doi: 10.1016/j.contraception.2006.02.003. Epub 2006 Mar 29.

Reference Type BACKGROUND
PMID: 16730497 (View on PubMed)

Hubacher D, Lara-Ricalde R, Taylor DJ, Guerra-Infante F, Guzman-Rodriguez R. Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women. N Engl J Med. 2001 Aug 23;345(8):561-7. doi: 10.1056/NEJMoa010438.

Reference Type BACKGROUND
PMID: 11529209 (View on PubMed)

Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J. Cost effectiveness of contraceptives in the United States. Contraception. 2009 Jan;79(1):5-14. doi: 10.1016/j.contraception.2008.08.003. Epub 2008 Sep 25.

Reference Type BACKGROUND
PMID: 19041435 (View on PubMed)

Steinberg JR, Adler NE, Thompson KM, Westhoff C, Harper CC. Current and past depressive symptoms and contraceptive effectiveness level method selected among women seeking reproductive health services. Soc Sci Med. 2018 Oct;214:20-25. doi: 10.1016/j.socscimed.2018.08.009. Epub 2018 Aug 13.

Reference Type DERIVED
PMID: 30138841 (View on PubMed)

Rocca CH, Goodman S, Grossman D, Cadwallader K, Thompson KMJ, Talmont E, Speidel JJ, Harper CC. Contraception after medication abortion in the United States: results from a cluster randomized trial. Am J Obstet Gynecol. 2018 Jan;218(1):107.e1-107.e8. doi: 10.1016/j.ajog.2017.09.020. Epub 2017 Oct 3.

Reference Type DERIVED
PMID: 28986072 (View on PubMed)

Gibbs SE, Rocca CH, Bednarek P, Thompson KMJ, Darney PD, Harper CC. Long-Acting Reversible Contraception Counseling and Use for Older Adolescents and Nulliparous Women. J Adolesc Health. 2016 Dec;59(6):703-709. doi: 10.1016/j.jadohealth.2016.07.018. Epub 2016 Sep 21.

Reference Type DERIVED
PMID: 27665153 (View on PubMed)

Other Identifiers

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2010-5442

Identifier Type: -

Identifier Source: org_study_id

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