Objective
To introduce and promote the use of long-acting reversible methods of contraception
(LARC; intrauterine contraceptives and subdermal implant) by removing financial and
knowledge barriers.
Study Design
The Contraceptive CHOICE Project is a prospective cohort study of 10,000 women 14-45
years who want to avoid pregnancy for at least 1 year and are initiating a new form
of reversible contraception. Women screened for this study are read a script regarding
long-acting reversible methods of contraception to increase awareness of these options.
Participants choose their contraceptive method that is provided at no cost. We report
the contraceptive choice and baseline characteristics of the first 2500 women enrolled
August 2007 through December 2008.
Results
Sixty-seven percent of women enrolled (95% confidence interval, 65.3–69.0) chose long-acting
methods. Fifty-six percent selected intrauterine contraception and 11% selected the
subdermal implant.
Conclusion
Once financial barriers were removed and long-acting reversible methods of contraception
were introduced to all potential participants as a first-line contraceptive option,
two-thirds chose long-acting reversible methods of contraception.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.Perspect Sex Reprod Health. 2006; 38: 90-96
- Contraceptive use among U.S. women having abortions in 2000-2001.Perspect Sex Reprod Health. 2002; 34: 294-303
- Factors associated with contraceptive choice and inconsistent method use, United States, 2004.Perspect Sex Reprod Health. 2008; 40: 94-104
- Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth.Natl Center Health Stat. 2005; 23: 95
- U.S. women's perceptions of and attitudes about the IUD.Obstet Gynecol Surv. 1996; 51: S30-S34
- Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods.J Fam Plann Reprod Health Care. 2008; 34: 213-217
- Challenges in translating evidence to practice: the provision of intrauterine contraception.Obstet Gynecol. 2008; 111: 1359-1369
- Intrauterine contraception in Saint Louis: a survey of obstetrician and gynecologists' knowledge and attitudes.Contraception. 2010; 81: 112-116
- Cost effectiveness of contraceptives in the United States.Contraception. 2009; 79 (Erratum in: Contraception 2009;80:2229-30): 5-14
- Initiation of oral contraceptives—start now!.J Adolesc Health. 2008; 43: 432-436
- Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled trial.Obstet Gynecol. 2007; 109: 1270-1276
- Quick start: novel oral contraceptive initiation method.Contraception. 2002; 66: 141-145
- A modified poisson regression approach to prospective studies with binary data.Am J Epidemiol. 2004; 159: 702-706
- Obstetrician-gynecologists and the intrauterine device: a survey of attitudes and practice.Obstet Gynecol. 2002; 99: 275-280
- Adolescent and young adult women's knowledge of and attitudes toward the intrauterine device.Contraception. 2008; 78: 211-217
- A comparison of contraceptive procurement pre- and post-benefit change.Contraception. 2007; 76: 360-365
- Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion.Contraception. 2008; 78: 136-142
- A randomized trial of the intrauterine contraceptive device vs hormonal contraception in women who are infected with the human immunodeficiency virus.Am J Obstet Gynecol. 2007; 197: 144.e1-144.e8
Article Info
Publication History
Published online: June 11, 2010
Accepted:
April 12,
2010
Received in revised form:
February 17,
2010
Received:
October 17,
2009
Footnotes
Supported by an anonymous foundation. This research was also supported in part by a Midcareer Investigator Award in Women's Health Research ( K24 HD01298 ), by a Clinical and Translational Science Award ( UL1RR024992 ), and by Grant no. KL2RR024994 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research .
Reprints not available from the authors.
The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.
Cite this article as: Secura GM, Allsworth JE, Madden T, et al. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol 2010;203:115.e1-7.
Identification
Copyright
© 2010 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
