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


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


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


Trainee Demographics


Clinical Practice Locations of 295 LARC-trained clinicians from 32 States & the Virgin Islands


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


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


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®


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


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


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



the title x larc initiative -...

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