Providers’ Knowledge, Perceptions and Views of Prescribing Long-Acting Reversible Contraception to Adolescents in a Southwest Community Health Center

Abstract

This paper describes a Doctor of Nursing Practice (DNP) quality improvement project that identifies provider’s knowledge, perceptions, and views surrounding the prescription of long- acting reversible contraception (LARC) to female adolescents, ages 15 to 19, for the purposes of reducing unintended adolescent pregnancy. LARCs are the most effective contraceptive methods, however, remain significantly underutilized in the United States (U.S.), and particularly among the adolescent population. This project aimed to identify facilitators and barriers to counseling and prescribing adolescents on LARC methods within a southwestern urban Community Health Center (CHC). This project was guided by the Theory of Planned Behavior (TBP) to describe providers’ intention to counsel and prescribe LARC methods to adolescents. This project employed a descriptive design and utilized a quantitative survey distributed to selected providers within this CHC. Response rate was approximately 14%. Key findings suggest providers are particularly knowledgeable of LARC methods and recommendations discussed in current contraceptive evidence-based guidelines. Despite this knowledge, the most frequent contraceptive methods prescribing in this CHC are the oral contraceptive pill (OCP) and the injectable (Depo-Provera). Primary barriers to LARC are identified as providers’ faulty perceptions of LARC and organizational concerns. Overall, this project was successful in identifying provider-based influences that act as barriers and subsequently limit the prescription of LARC to adolescents. Recommendations are made to enhance providers’ LARC counseling and prescribing practices pertaining to 1) how often contraceptive counseling occurs, 2) requirements warranted prior to LARC initiation, and 3) recognizing and addressing providers’ flawed perceptions on LARC use in adolescents.