Contraceptive Implant Knowledge and Practices of Providers Serving an Urban, Low-Income Community

Contraceptive implants are highly effective but infrequently used by low-income women, who are at high risk of unintended pregnancy. Provider factors that may affect implant acceptance merit further exploration. We surveyed 66 clinicians serving an urban, low-income community from adult primary care...

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Bibliographic Details
Published in:Journal of health care for the poor and underserved 2014-08, Vol.25 (3), p.1308-1316
Main Authors: Collier, Charlene H, Rosenthal, Marjorie, Harris, Kenn, Lucas, Georgina, Stanwood, Nancy L
Format: Article
Language:English
Subjects:
Acceptances
Adolescent
Adolescents
Adult
Adults
Birth Control
Candidates
Clinical Competence
Clinics
Community-Based Participatory Research
Connecticut
Contraceptive Agents, Female
Contraceptives
Cost
Counseling
Education
Female
Females
Health Care Services
Hospitals
Humans
Income
Knowledge
Likert scale
Low Income Groups
Male
Medical service
Middle Aged
Midwifery
Obstetrics
Patient Selection
Patients
Poverty Areas
Practice Patterns, Nurses' - statistics & numerical data
Practice Patterns, Physicians' - statistics & numerical data
Pregnancy
Primary care
Primary Health Care
Reproductive health
Risk
Studies
Transplants & implants
Urban Areas
Urban Population
Women
Womens health
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Description
Summary:Contraceptive implants are highly effective but infrequently used by low-income women, who are at high risk of unintended pregnancy. Provider factors that may affect implant acceptance merit further exploration. We surveyed 66 clinicians serving an urban, low-income community from adult primary care, women's health, and adolescent practices. We assessed implant education, knowledge, perceptions of accessibility and cost, and patient selection practices. Education about implants varied from 15% in adult primary care to 30% in adolescent practice and 75% in women's health. Among women's health providers, 54% were trained to insert implants. Despite having eligible candidates, some providers were unlikely to recommend implants to patients who are nulliparous (8%), teens (22%), depressed (24%) or obese (22%). Forty-one percent of providers reported insertion wait-times of at least three weeks. Among low-income women, deficits in provider education, restrictive practice patterns, and long insertion wait times may affect contraceptive implant use.
ISSN:1049-2089
1548-6869
1548-6869
DOI:10.1353/hpu.2014.0128