Sustainable and effective methods to increase long-acting reversible contraception uptake from the ACCORd general practice trial.
general practice
long-acting reversible contraception
normalisation process theory
process evaluation
randomised controlled trial
Journal
Australian and New Zealand journal of public health
ISSN: 1753-6405
Titre abrégé: Aust N Z J Public Health
Pays: United States
ID NLM: 9611095
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
revised:
01
10
2021
received:
01
06
2021
accepted:
01
02
2022
pubmed:
14
5
2022
medline:
5
8
2022
entrez:
13
5
2022
Statut:
ppublish
Résumé
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. 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. 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. 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. Improving Australian women's access to and use of LARCs is sustainable with EBCC training and support for general practitioners.
Identifiants
pubmed: 35557481
doi: 10.1111/1753-6405.13242
doi:
Substances chimiques
Contraceptive Agents, Female
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
540-544Subventions
Organisme : National Health and Medical Research Council of Australia
Organisme : Australian National Health and Medical Research Council
ID : 1081743
Informations de copyright
© 2022 The Authors.
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