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

Taft, A; Watson, CJ; McCarthy, E; Black, KI; Lucke, J; McGeechan, K; Haas, M; McNamee, K; Peipert, JF; Mazza, D

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

Taft, A Watson, CJ McCarthy, E Black, KI Lucke, J McGeechan, K Haas, M

McNamee, K Peipert, JF Mazza, D

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Publisher:: Wiley Open Access
Publication Type:: Journal Article
Citation:: Australian and New Zealand Journal of Public Health, 2022, 46, (4), pp. 540-544
Issue Date:: 2022-08

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Field	Value	Language
dc.contributor.author	Taft, A
dc.contributor.author	Watson, CJ
dc.contributor.author	McCarthy, E
dc.contributor.author	Black, KI
dc.contributor.author	Lucke, J
dc.contributor.author	McGeechan, K
dc.contributor.author	Haas, M https://orcid.org/0000-0002-9726-3063
dc.contributor.author	McNamee, K
dc.contributor.author	Peipert, JF
dc.contributor.author	Mazza, D
dc.date.accessioned	2022-11-30T03:43:37Z
dc.date.available	2022-02-01
dc.date.available	2022-11-30T03:43:37Z
dc.date.issued	2022-08
dc.identifier.citation	Australian and New Zealand Journal of Public Health, 2022, 46, (4), pp. 540-544
dc.identifier.issn	1326-0200
dc.identifier.issn	1753-6405
dc.identifier.uri	http://hdl.handle.net/10453/163901
dc.description.abstract	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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley Open Access
dc.relation.ispartof	Australian and New Zealand Journal of Public Health
dc.relation.isbasedon	10.1111/1753-6405.13242
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services, 1402 Applied Economics, 1605 Policy and Administration
dc.subject.classification	Public Health
dc.subject.mesh	Australia
dc.subject.mesh	Contraception
dc.subject.mesh	Contraceptive Agents, Female
dc.subject.mesh	Female
dc.subject.mesh	General Practice
dc.subject.mesh	General Practitioners
dc.subject.mesh	Humans
dc.subject.mesh	Long-Acting Reversible Contraception
dc.subject.mesh	Australia
dc.subject.mesh	Contraception
dc.subject.mesh	Contraceptive Agents, Female
dc.subject.mesh	Female
dc.subject.mesh	General Practice
dc.subject.mesh	General Practitioners
dc.subject.mesh	Humans
dc.subject.mesh	Long-Acting Reversible Contraception
dc.subject.mesh	Humans
dc.subject.mesh	Contraceptive Agents, Female
dc.subject.mesh	Contraception
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	General Practitioners
dc.subject.mesh	General Practice
dc.subject.mesh	Long-Acting Reversible Contraception
dc.title	Sustainable and effective methods to increase long-acting reversible contraception uptake from the ACCORd general practice trial.
dc.type	Journal Article
utslib.citation.volume	46
utslib.location.activity	Australia
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
utslib.for	1605 Policy and Administration
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-11-30T03:43:36Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	46
utslib.citation.issue	4

Abstract:

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.

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http://hdl.handle.net/10453/163901