Community initiative increases teenage use of effective contraception


Date:
July 9, 2020
Source:
University of Rochester Medical Center
Summary:
Study finds that teenagers utilize Long-Acting Reversible
Contraception (LARC) at a rate five times higher than the United
States as a whole.



FULL STORY ==========================================================================
A new study published in the American Journal of Obstetrics &
Gynecology shows that a University of Rochester Medical Center (URMC)
community outreach initiative has helped adolescents in Rochester adopt long-acting reversible contraception (LARC) at a rate far higher than
the U.S. overall.


==========================================================================
The study, "Impact of the Rochester LARC Initiative on Adolescents'
Utilization of Long-Acting Reversible Contraception," used Youth Risk
Behavior Surveillance System data from the years 2013, 2015, and 2017
for Rochester, New York City, New York State, and the U.S. overall. These
years cover the time before and after the Initiative began in 2014.

The study found that usage of LARC among sexually active high school
females in Rochester increased from 4 to 24 percent from 2013-2017,
compared to an increase from 2.7 to 5.3 percent in New York City, 1.5 to
4.8 percent in New York State, and 1.8 to 5.3 percent in the U.S. overall.

The Greater Rochester LARC Initiative was started six years ago by the Hoekelman Center for Health Beyond Medicine, a unit of the URMC Department
of Pediatrics that connects doctors with non-profits to benefit kids
and adults by making communities healthier places to live. Primarily
funded by the Greater Rochester Health Foundation, the Initiative aims to increase access to highly effective methods of birth control, including intrauterine devices and contraceptive implants (LARCs) for adolescents
in Rochester.

Andrew Aligne, M.D., M.P.H., director of the Hoekelman Center, and
his team have led the community effort to promote LARC by conducting
outreach to local organizations that work with youth. They employ a
simple "lunch-and-learn" approach to disseminate accurate information
that forms the backbone of the Hoekelman Center's advocacy work.

"An interesting aspect of the LARC project is that we talk to adults,
not to teens. We work with our community partners to teach adults about
birth control.

This way, they can help teens to make well-informed choices about
preventing unintended pregnancy," says Jessica VanScott, M.P.H., the
LARC Initiative's health project coordinator.



========================================================================== Through their research with area teens, the LARC project team found
that many were interested in learning about birth control, and that they
often asked their most trusted peers and adults for advice.

"If teens are learning outside the medical setting from trusted youths
and adults, then how do we increase the likelihood that anyone they talk
to will share accurate information? We thought it could help if we gave resources with useful information to adults who work with teens in the community," said Aligne, associate professor of Pediatrics at URMC.

So far, the team has presented to more than 2,700 adults in health
care settings, as well as those in community settings such as staff of after-school programs. The talks provide information about the safety, efficacy, and availability of LARC, with the goal of improving knowledge
and access at the community level.

This approach is different from previous attempts to disseminate
information about LARC. Typically, past outreach efforts have focused
on targeting primary care providers or utilizing advertising resources
to raise awareness. The Hoekelman Center's community-based approach
achieved strong results because few of these community organizations
had ground-level information available about LARC, according to Aligne.

"Almost nobody knew that the LARC program was free and covered by
Medicaid," said Aligne. 26 states offer reimbursement for LARC under the Medicaid Family- Planning Benefit -- included as part of the Medicaid
expansion in the Affordable Care Act (ACA) -- and Aligne believes these
states could scale-up the Hoekelman Center's model to raise awareness
as well.



========================================================================== Studies have shown that unintended teen pregnancy can lead to a number of critical health and social problems for young parents and their children:
low birth weight, unemployment, school failure, and many other serious
issues.

Because of these risks, the Centers for Disease Control and Prevention
(CDC) has declared teen pregnancy a national public health priority,
and the CDC - - along with the American Academy of Pediatrics and
the American College of Obstetricians and Gynecologists -- recommends
LARC as a safe and highly effective method of pregnancy prevention for adolescents seeking contraception.

"LARCs are more effective than pills, patches, and other contraceptives
because they remain in place all the time," said Katherine Greenberg,
M.D., an adolescent medicine specialist at UR Medicine's Golisano
Children's Hospital.

"Today's LARCs are safe, effective, invisible, and can be easily removed
with no lingering effects when you decide to become pregnant." LARC
methods protect against pregnancy for up to three to 12 years, can be
removed at any time, and are 40 times more effective for teens than the traditional birth control pill.

The Hoekelman Center's efforts are bolstered by an extensive network
of local agencies, including the Initiative's core partners: the Metro
Council for Teen Potential, Healthy Baby Network, Highland Family
Planning, and Planned Parenthood of Central and Western New York.

"As we strive to fulfill our mission to pursue and invest in solutions
that build a healthier region where all people can thrive, we are proud
to support the LARC Initiative at URMC, and celebrate its successes,"
said Matthew Kuhlenbeck, president and CEO of the Greater Rochester
Health Foundation.

"The LARC project team takes a proactive, practical approach in
its efforts to help reduce teen pregnancy by sharing information and
increasing awareness of options, and we are especially grateful for the collaboration among URMC and community partners who are working together
to address this challenge." LARC services have continued during COVID-19,
and access expanded at an increasing number of primary care practices
serving teens and young adults throughout the Finger Lakes region
during the last year, thanks to Accountable Health Partners (AHP),
URMC's clinically integrated network of hospitals and physicians. In partnership with the Hoekelman Center team, and funded by a grant from
the Finger Lakes Performing Provider System (FLPPS), AHP has promoted
training in both reproductive counseling and LARC placement for primary
care providers in order to further reduce access barriers for patients.

"The LARC Initiative demonstrates true collaboration between health care
and community and is a significant population health success for our
region," said Laura Jean Shipley, M.D., professor of clinical pediatrics,
vice chair for Population and Behavioral Health at URMC and associate
medical director at AHP.


========================================================================== Story Source: Materials provided by
University_of_Rochester_Medical_Center. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. C. Andrew Aligne, Rachael Phelps, Jessica L. VanScott, Sarah
A. Korones,
Katherine B. Greenberg. Impact of the Rochester LARC Initiative
on adolescents' utilization of long-acting reversible contraception.

American Journal of Obstetrics and Gynecology, 2020; 222 (4):
S890.e1 DOI: 10.1016/j.ajog.2020.01.029 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200709172850.htm

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