Social Networks and Peer Education Improve Knowledge, Attitudes About LARC

May 6, 2013

New Orleans, LA -- Using social networks and peer education may be a way to increase acceptance of long-acting reversible contraception (LARC) among low-income women, according to a community-based research study presented today at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists.  

LARC includes intrauterine devices (IUDs) and the subdermal implant. LARC methods can be put in place and require nothing of the user while providing effective contraception for an extended time.

Charlene H. Collier, MD, MPH, a Robert Wood Johnson Foundation Clinical Scholar at Yale University in New Haven, CT, and her colleagues developed and administered a survey to urban women with family incomes below 200% of the federal poverty level. “We were interested in this population because low-income women have higher rates of unintended pregnancy,” Dr. Collier said.

Along with community partner New Haven Healthy Start, the team recruited 200 women with an average age of 27 to take the survey at outdoor health fairs, local beauty salons, and bus stops. The survey assessed the women’s contraceptive experience, reproductive intentions, and LARC awareness, knowledge, and interest. Of the women, 39% were black, 40%, Hispanic, and 14%, white.

More than half (54%) of study participants were current contraceptive users, and 39% reported not desiring pregnancy within five years. Sixty-three percent were aware of IUDs, and 37% knew how long an IUD could be used. Most respondents were unsure if IUDs were safe (59%) or effective (64%). Almost half (45%) were aware of implants, yet most reported not knowing how long they lasted (90%) or if they were safe (72%) or effective (77%). Among women aware of IUDs, 21% said they could consider using one. Interest in using an IUD was associated with having a friend who had one, as well as wanting to delay pregnancy for two to five years. Among women aware of implants, 18% said they would consider using one. Implant interest was associated with Latino ethnicity and having a friend with an implant.

The study highlighted that awareness and interest in LARC is particularly low in this population. Dr. Collier and her colleagues said that limiting contraception educational efforts to just clinical settings may not be enough to change currently held beliefs about LARC methods.

Dr. Collier said she hopes the study will promote efforts to dispel misinformation and increase education about these highly effective forms of birth control. “A lot of the responses centered on fear of side effects,” she said, adding that there were also misconceptions that LARC methods caused cancer or infertility. Cost was not a major factor reported by women; in some instances, Medicaid covers the cost of birth control for many low-income women.

Along with support from the Robert Wood Johnson Foundation, Dr. Collier funded the work with a $5,000 trainee research award from the Society of Family Planning, a national grant competition.

*Monday Poster #4: A Community-Based Survey of Low-Income Women’s Knowledge and Interest in LARC

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 57,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization.


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