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Sustainable and effective methods to increase long-acting reversible contraception uptake from the ACCORd general practice trial

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posted on 2022-09-29, 05:53 authored by Angela TaftAngela Taft, CJ Watson, E McCarthy, KI Black, Jayne LuckeJayne Lucke, K McGeechan, M Haas, K McNamee, JF Peipert, D Mazza
Objective: Most Australian women access contraception through general practitioners (GPs) but choose oral methods rather than long-acting reversible contraceptives (LARCS). The Australian Contraceptive ChOice pRoject (ACCORd) successfully tested a complex intervention for LARC uptake. We aimed to explore the critical elements of this intervention to increase LARC uptake. Design: ACCORd was a cluster randomised control trial conducted in 57 GP clinics in Melbourne, Australia. To explore intervention impact, fidelity checks (n=21 GPs) and interviews with 37 GPs and 40 patients were undertaken 12 months after initial consultations. Data were inductively coded, thematically analysed and mapped to Normalization Process Theory constructs. Results: Doctors understood the importance of effectiveness-based contraceptive counselling (EBCC). GPs demonstrated cognitive engagement in the promotion of LARC and some appreciated the rapid referral pathways. GPs and women valued the effectiveness approach. GPs held varying views about having a rapid referral pathway, with many already having established pathways in place. Some GPs viewed intrauterine device insertion costs or insertion training as barriers to ongoing practice. Most GPs and women saw the ACCORD model as effective and sustainable. Conclusions: GP training in EBCC and the use of rapid referral pathways were critical features of an effective sustainable model for successful uptake of LARCs in primary care. Implications for public health: Improving Australian women's access to and use of LARCs is sustainable with EBCC training and support for general practitioners.

Funding

The ACCORD trial was funded by the Australian National Health and Medical Research Council; Grant No.1081743

History

Publication Date

2022-08-01

Journal

Australian and New Zealand Journal of Public Health

Volume

46

Issue

4

Pagination

5p. (p. 540-544)

Publisher

Wiley

ISSN

1326-0200

Rights Statement

© The Authors 2022. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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