Increasing long-acting reversible contraceptives: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomized trial

Abstract Background Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth. Methods This study is a cluster-randomized trial of communities in rural Guatemala where women receive ante- and postnatal care through a community-based nursing program. When nurses visit women for their postpartum visit in the intervention clusters, instead of providing only routine care that includes postpartum contraceptive education and counseling, the nurses will also bring a range of barrier, short-acting, and long-acting contraceptives that will be offered and administered in the home setting, after routine clinical care is provided. Discussion A barrier to postpartum contraception is access to medications and devices. Our study removes some access barriers (distance, time, cost) by providing contraception in the home. We also trained community nurses to place implants, which are a type of long-acting reversible contraceptive method that was previously only available in the closest town, which is about an hour away by vehicle. Therefore, our study examines how home-based delivery of routinely available contraceptives and the less routinely available implant may be associated with increased uptake of postpartum contraception within three months of childbirth. The potential implications of this study include: nurses may be able to be trained to safely provide contraceptives, including place implants, in the home setting, and provision of home-based contraception may be an effective way of delivering an evidence-based intervention for preventing unintended and closely spaced pregnancies in the postpartum period. Retrospective Trial Registration clinicaltrials.gov Trial Identifying Number NCT04005391 Date of Registration in Primary Registry: July 1, 2019 Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04005391?term=NCT04005391&rank=1 Keywords: postpartum contraception, long-acting reversible contraceptives, implant, nursing, community programming, cluster-randomized trial

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Delivery of home-based postpartum contraception in rural Guatemalan women: a cluster-randomized trial protocol

Trials ◽

10.1186/s13063-019-3735-3 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Margo S. Harrison ◽

Saskia Bunge-Montes ◽

Claudia Rivera ◽

Andrea Jimenez-Zambrano ◽

Gretchen Heinrichs ◽

...

Keyword(s):

Randomized Trial ◽

Clinical Care ◽

Cluster Randomized Trial ◽

Routine Care ◽

Postpartum Visit ◽

Postpartum Contraception ◽

Home Setting ◽

Home Based ◽

Cluster Randomized ◽

Long Acting

Abstract Background Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth. Methods This study is a cluster-randomized trial of communities in rural Guatemala where women receive ante- and postnatal care through a community-based nursing program. When nurses visit women for their postpartum visit in the intervention clusters, instead of providing only routine care that includes postpartum contraceptive education and counseling, the nurses will also bring a range of barrier, short-acting, and long-acting contraceptives that will be offered and administered in the home setting, after routine clinical care is provided. Discussion A barrier to postpartum contraception is access to medications and devices. Our study removes some access barriers (distance, time, cost) by providing contraception in the home. We also trained community nurses to place implants, which are a type of long-acting reversible contraceptive method that was previously only available in the closest town which is about an hour away by vehicular travel. Therefore, our study examines how home-based delivery of routinely available contraceptives and the less routinely available implant may be associated with increased uptake of postpartum contraception within 3 months of childbirth. The potential implications of this study include that nurses may be able to be trained to safely provide contraceptives, including placing implants, in the home setting, and provision of home-based contraception may be an effective way of delivering an evidence-based intervention for preventing unintended and closely spaced pregnancies in the postpartum period. Trial registration Clinicaltrials.gov, NCT04005391. Retrospectively registered on 1 July 2019.

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Funding policies and postabortion long-acting reversible contraception: results from a cluster randomized trial

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2015.12.009 ◽

2016 ◽

Vol 214 (6) ◽

pp. 716.e1-716.e8 ◽

Cited By ~ 16

Author(s):

Corinne H. Rocca ◽

Kirsten M.J. Thompson ◽

Suzan Goodman ◽

Carolyn L. Westhoff ◽

Cynthia C. Harper

Keyword(s):

Randomized Trial ◽

Cluster Randomized Trial ◽

Funding Policies ◽

Cluster Randomized ◽

Long Acting

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Delivery of home-based postpartum contraception in rural Guatemalan women: a cluster-randomized trial protocol

10.21203/rs.2.12494/v2 ◽

2019 ◽

Author(s):

Margo Harrison ◽

Saskia Bunge-Montes ◽

Claudia Rivera ◽

Andrea Jimenez-Zambrano ◽

Gretchen Heinrichs ◽

...

Keyword(s):

Randomized Trial ◽

Clinical Care ◽

Cluster Randomized Trial ◽

Routine Care ◽

Postpartum Visit ◽

Postpartum Contraception ◽

Home Setting ◽

Home Based ◽

Cluster Randomized ◽

Long Acting

Abstract Abstract Background: Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth. Methods: This study is a cluster-randomized trial of communities in rural Guatemala where women receive ante- and postnatal care through a community-based nursing program. When nurses visit women for their postpartum visit in the intervention clusters, instead of providing only routine care that includes postpartum contraceptive education and counseling, the nurses will also bring a range of barrier, short-acting, and long-acting contraceptives that will be offered and administered in the home setting, after routine clinical care is provided. Discussion: A barrier to postpartum contraception is access to medications and devices. Our study removes some access barriers (distance, time, cost) by providing contraception in the home. We also trained community nurses to place implants, which are a type of long-acting reversible contraceptive method that was previously only available in the closest town, which is about an hour away by vehicle. Therefore, our study examines how home-based delivery of routinely available contraceptives and the less routinely available implant may be associated with increased uptake of postpartum contraception within three months of childbirth. The potential implications of this study include: nurses may be able to be trained to safely provide contraceptives, including place implants, in the home setting, and provision of home-based contraception may be an effective way of delivering an evidence-based intervention for preventing unintended and closely spaced pregnancies in the postpartum period.

Download Full-text