Seventy-five percent of pregnancies among adolescents are unplanned and every day in the state of Minnesota, approximately eight adolescents become pregnant and six give birth. Long-acting reversible contraceptives (LARCs), including intrauterine devices (IUDs) and etonogestrel implants (Nexplanon), are the first-line contraceptive method for adolescents, yet fewer than 5 percent of adolescents ages 15-19 use these methods. In 2014, the American Academy of Pediatrics (AAP) joined the Institute of Medicine, the American College of Obstetricians and Gynecologist, and the American Academy of Family Medicine in recommending LARCs as first-line contraception for adolescents. Although pediatricians are well-positioned to increase adolescent LARC use, provider knowledge, attitudes and experience remain a barrier, resulting in missed opportunities to prevent teen pregnancy.
A multidisciplinary, trainee-led team from the University of Minnesota conducted a needs assessment among pediatric community clinicians and trainees. It revealed two key findings: (1) few pediatric providers in our community were providing LARCs, and (2) the vast majority (88 percent) of pediatric trainees desired LARC training, yet opportunities were limited.
To address this gap, in July 2018, the trainee-led team launched monthly LARC workshops for pediatric community clinicians and trainees. This free 3.5-hour workshop includes an interactive educational session on LARC methods, followed by hands-on etonogestrel implant (Nexplanon) training and certification.
To date, a total of 147 clinicians have participated in the LARC workshop – 52 medical residents and fellows (35 percent), 58 advanced practice providers (39 percent), and 19 attending physicians (13 percent). Clinicians who have attended the workshop report increased knowledge and comfort with LARC methods and are more likely to recommend and provide LARCs in their clinics.
We are all too familiar with the missed opportunities to prevent unplanned teen pregnancy and as pediatricians; we are uniquely positioned to make a difference.
We hope to see you at one of the upcoming trainings!
For more information and to sign up, please contact Alex Prince by email firstname.lastname@example.org.
Quick Facts: Long Acting Reversible Contraceptives (LARCs)
They are the most effective form of reversible contraception.
There are very few contraindications.
They are safe and well-tolerated among adolescents.
Adolescents prefer LARCs compared to other contraceptive methods.
About the Authors
Taylor A. Argo, MD; Janna R. Gewirtz O’Brien MD, FAAP; Kathleen K. Miller, MD, FAAP; Emily Borman-Shoap MD, FAAP authored the content for this article.
Alexandra Prince, Tori Bahr, MD, Christy Boraas, MD, MPH, Nicole Chaisson, MD, MPH, collaborated on this project.