The Title X LARC Initiative -...
Transcript of The Title X LARC Initiative -...
The Title X LARC Initiative
Supported by the Department of Health and Human Services/Office of Population Affairs/Office of Family Planning
Grant 5 FPTPA006002-07-00
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
Title X LARC Program Overview In order to increase Long Acting Reversible Contraception (LARC) as a family planning option at Title X agencies, the Office of Population Affairs (OPA) provides funding for LARC trainings throughout the U.S.
A combination of didactic & hands-on skills training, designed to provide advanced practice clinicians & physicians with an overview of the safety and effectiveness, proper placement, & proper removal of:
Mirena®IUC (levonorgestrel-releasing intrauterine system)
ParaGard® IUC (intrauterine copper contraceptive)
Skyla® IUC (levonorgestrel-releasing intrauterine system)
Nexplanon® (etonogestrel implant) *training conducted by Merck
Offered in conjunction with Preceptor Training, Billing & Coding, select national & local conferences
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
Title X LARC Program Overview
2.75 continuing education credit hours for IUC training
Free of charge for Title X clinicians Travel stipends available for Title X clinicians
⁻ Air, train, auto travel to training; ground transportation; parking; lodging
⁻ Attracts trainees
⁻ Alleviates costs to Title X agencies
⁻ 47 (44%) of 107 trainees applied for stipends since travel assistance funds
became available in 2013
LARC Mentoring
⁻ connects experienced LARC clinicians with less experienced LARC trainees
for guidance & support as they begin placements in patients
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
LARC Trainee Summary 11 Title X LARC trainings have been held since March 2011
295 clinicians have attended a LARC training
208 clinicians completed IUC training
207 clinicians completed Nexplanon® training
LARC TRAINING DATE
LOCATION
TOTAL #
CLINICIANS TRAINED
IUC
NEXPLANON®
March 25, 2011 Portland, OR 33 18 16
April 8, 2011 Kansas City, MO 23 9 14
May 12, 2011 Denver, CO 28 27 25
June 8, 2011 Baltimore, MD 18 17 11
December 19, 2011 Marlborough, MA 21 16 14
March 22-23, 2012 Kansas City, MO 39 26 25
April 18, 2012 Milwaukee, WI 14 9 12
May 9, 2012 Las Vegas, NV 12 11 8
March 13, 2013 Orlando, FL 30 29 26
March 21-22, 2013 Kansas City, MO 42 24 30
May 1, 2013 Denver, CO 35 22 26
TOTAL CLINICIANS TRAINED 295 208 207
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
Trainee Demographics
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
Clinical Practice Locations of 295 LARC-trained clinicians from 32 States & the Virgin Islands
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
LARC Mentors LARC Mentor Matching option connects experienced LARC clinicians with less experienced Title X LARC clinicians in their geographic area for guidance & support as they begin LARC placements in patients. 36 clinicians nationwide have been accepted as mentors
• 30 requests for a mentor • 15 matched with a mentor • 8 self-identified their own mentor • 7 pending
LARC Mentors Receive: • $250 for each 4 hours of pre-approved mentoring • Travel stipend • Mentor kit of training supplies
Mentors should be very comfortable placing & removing IUCs &/or contraceptive implants Mentors should be committed to increasing the capacity of LARC in the Title X system Mentorships can be done at mentor’s or mentee’s clinic Mentors must have current medical malpractice insurance Mentor arrangements based on location & availability No guarantee mentor services will be needed
Apply to be a LARC Mentor online at http://www.ctcfp.org/larc
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
Evaluation
138 trainees (47%) participated in follow up evaluation:
• 98 trainees completed 3 month follow up survey online
• 62 trainees completed 6 month follow up survey online
• 33 trainees surveyed via telephone
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
Significant Findings
LARC placement (n =138)
96 trainees (70%) have placed at least 1 LARC since training:
• 61 trainees (44%) have placed at least 1 Paragard®
• 67 trainees (49%) have placed at least 1 Mirena®
• 53 trainees (53%) have placed at least 1 Nexplanon®
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
Significant Findings
Example self-reported LARC placements of individual clinicians post-training include:
•100 Paragards®, 30 Mirenas®
•40 Paragards®, 40 Mirenas®, 7 Nexplanons®
• 5 Paragards®, 25 Mirenas®, 30 Nexplanons®
3 clinicians from 1 Title X clinic attended LARC training, followed by a half-day session with a LARC mentor, and over the next 9 months they placed a combined total of 144 IUCs
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
LARC Barriers • 39 (28%) no barriers to LARC at their site
• 39 (28%) patient resistance
• 17 (12%) institutional protocols and/or administrative resistance
• 55 (40%) lack of clinic funding for Nexplanon®
34 (25%) lack of clinic funding for Mirena®
24 (12%) lack of clinic funding for Paragard®
• 67% would like better patient education materials
• 32% would like additional opportunities with mentor
LARC Assistance
Family Planning National Clinical Training Center · Supported by Office of Population Affairs
UPCOMING LARC TRAININGS:
• SEPTEMBER 11, 2013 – KANSAS CITY, MO
• OCTOBER 16, 2013 – CHARLESTON, SC
For more information, or to register, visit:
http://www.ctcfp.org/larc