Rochester Community Initiative Increases Use of Long-Acting Reversible Contraceptives in Adolescence

Reviewed by Emily Henderson, B.Sc.July 9, 2020

New research published in American Journal of Obstetrics & Gynecology A community outreach initiative at the University of Rochester Medical Center (URMC) shows that adolescents in Rochester are able to adopt long-acting reversible contraception (LARC) at a much higher rate than in the entire United States. ..

The study, “The Impact of the Rochester LARC Initiative on Adolescent Reversible Contraceptive Use,” used the 2013, 2015, and 2017 youth risk behavior monitoring system data from Rochester, New York, NY. The entire United States. These years cover the time before and after the initiative started in 2014.

LARC usage among women in sexually active high schools in Rochester increased from 4 to 24 percent from 2013 to 2017, 2.7 to 5.3 percent in New York City and 1.5 in New York State, according to a study. From 4.8%. 1.8-5.3% in the whole United States.

The Greater Rochester LARC Initiative was launched six years ago by the Hoekelman Center for Health Beyond Medicine, a URMC pediatric unit that connects doctors and non-profit organizations to benefit children and adults by making communities healthier. it was done. Funded primarily by the Greater Rochester Health Foundation, this initiative provides access to highly effective methods of contraception, including intrauterine contraceptive devices and contraceptive implants (LARCs) for adolescents in Rochester. Is intended to increase.

Andrew Aligne, MD, MPH, Head of Hoekelman Center, and his team have led the community’s efforts to drive LARC by outreaching local organizations that work with youth. They use a simple “lunch and learn” approach to disseminate the precise information that forms the backbone of the Hawkelmann Center’s advocacy efforts.

The interesting thing about the LARC project is talking to adults, not teens. Work with community partners to teach adults about contraception. In this way, they can help teens make well-informed choices about preventing unintended pregnancy. “

Jessica Vanscott, MPH, LARC Initiative Health Project Coordinator

Through a teenage community study, the LARC project team found that many are interested in learning about contraception and often seek advice from their most trusted peers or adults.

“When a teenager is learning from a trusted youth or adult outside the healthcare environment, how the community increases the likelihood that someone they’re talking to will share accurate information,” he said. Is Aligne, Associate Professor of Pediatrics at URMC.

So far, the team has given presentations to more than 2,700 adults in healthcare settings and to adults in the community, including after school program staff. The talks provide information about safety, efficacyLARC availability with the aim of improving knowledge and access at the community level.

This approach differs from previous attempts to disseminate information about LARC. Traditionally, outreach efforts to date have focused on targeting primary care providers or using advertising resources to raise awareness. According to Aligne, the Hoekelman Center’s community-based approach achieved strong results as few community organizations had access to ground-level information on LARC.

“No one knew that the LARC program was free and covered by Medicaid,” Aligne said. Twenty-six states offer reimbursement to LARC under Medicaid Family Planning Benefits (included as part of the Medicaid Expansion of Affordable Care Act (ACA)).

Studies show that unintentional teen pregnancy can cause some serious health and social problems in young parents and children: low birth weight, unemployment, school failure, and Many other serious problems. Because of these risks, the Centers for Disease Control and Prevention (CDC) has declared teenage pregnancy a national public health priority, and the CDC (along with the American Academy of Pediatrics and Obstetrics and Gynecologists) A safe and highly effective method of pregnancy prevention for adolescents seeking contraception.

“LARC is much more effective than pills, patches, and other contraceptives,” said Dr. Katherine Greenberg, adolescent health professional at UR Medicine Gorrisano Children’s Hospital. “Today’s LARC is safe, effective, invisible and can be easily removed if you decide to become pregnant without protracted effects.” LARC’s method is up to 3-12 Protects against pregnancy for years and can be removed at any time. Also, teens are 40 times more effective than traditional contraceptives.

The Haeckermann Center’s work is underpinned by an extensive network of local governments that are the core partners of the initiative. This is a planned parent-child relationship for Teen Potential Metro Council, Healthy Baby Network, Highland Family Planning, New York Central and West.

“We are committed to fulfilling our mission of seeking and investing in solutions that build a healthier area where all people can thrive. At URMC we can support the LARC initiative and celebrate its success. I’m proud of that,” said President and CEO Matthew Coolenbeck of the Greater Rochester Health Foundation.

“The LARC project team takes a proactive and hands-on approach to reducing teen pregnancies by sharing information and raising awareness of options. In particular, we work together to tackle this challenge. Thank you for the collaboration between URMC and our community partners.”

The LARC service continued through COVID-19 and served teens and adolescents across the Finger Lakes region last year thanks to Accountable Health Partners (AHP), URMC’s clinically integrated hospital network. Physicians with more primary care practices and increased access. AHP, partnered with the Hoekelman Center team and funded by a grant from the Finger Lakes Performing Provider System (FLPPS), AHP will provide reproductive counseling and LARC placement for primary care providers to further reduce access barriers to patients. We promote both types of training.

“The LARC Initiative demonstrates true collaboration between healthcare and community and is a success for the health of the population important to our region,” says Laura Jean Shipley, URMC Vice Chair for Health of Population and Behavior. The doctor says. AHP.