Describing Contemporary Use of Intrauterine Device Clinical Practice Guidelines for Adolescents in Southern Arizona

Abstract

Problem Statement: Unintended pregnancies (UP) are preventable life events that place both personal and societal strain accounting for approximately half of all pregnancies in the United States annually. Intrauterine devices (IUD) are highly effective forms of contraception that prevents UPs but are often underutilized due to several barriers including misconceptions about safety and efficacy, especially when considering adolescent women. Purpose: To describe contemporary use of IUD clinical practice guidelines (CPG) amongst various providers and to determine the effect of an evidence based educational intervention on perceptions and practice beliefs. Methods: Descriptive quantitative pretest posttest design with a brief educational intervention in the form of a PowerPoint presentation. All providers trained to counsel on and prescribe IUDs to adolescents within a large community health center in Tucson, Arizona were surveyed before and after the educational intervention to assess changes in perceptions and future practice patterns. Results: The provider responses indicate varying levels of limited provider knowledge related to selecting candidates, counseling on and prescribing IUDs to adolescent patients as dictated by current CPGs. The information also indicates that lack of knowledge may attribute to a perceived lack of confidence which may result in decreased numbers of IUDs being prescribed. Finally, post-education responses indicate a change in perceived self-efficacy and knowledge surrounding current CPG information. Significance: Targeted educational interventions for providers of contraception to adolescent patients positively affects adherence to evidence-based CPGs intended to reduce UP rates. Increased education also positively affects providers’ knowledge and perceived ability to safely counsel on and/or prescribe IUDs to nulliparous adolescents.