Barriers to Referring Adolescent Women for Etonogestrel Implant.

Not Applicable

Withdrawn

• Conditions: Contraceptive Usage
• Interventions: Behavioral: Education plus Coaching

• Registration Number: NCT04882137
• Lead Sponsor: Nemours Children's Clinic

Brief Summary

This study seeks to understand how much pediatric providers in Central Florida know about the etonogestrel contraceptive implant. The investigators also seek to understand the barriers that may prevent them from referring adolescent women for this highly effective and recommended method of contraception. Finally the study will consider if an expanded education and coaching improves their ability to referring patients for this method of birth control.

Detailed Description

This study is comprised of two phases. During the first phase 500 medical providers who provide care to adolescents will be recruited to complete a 30 question anonymous survey that evaluates their attitudes towards recommending and referring for adolescent women for the etonogestrel contraceptive device. This survey will also test participant's knowledge of indications, side effects and side effect management related to this contraceptive device as well.

During phase 2, 100 pediatric providers will be randomized to two groups. One group will receive standard continuing medical education on the use of the etonogestrel device in adolescents focusing on themes that emerged as knowledge deficits in phase 1. The other group will receive standard continuing medical education plus continued coaching on management of medication side effects. The referring patterns of physicians in each group will be studied.

Study Timeline

• Study First Submitted: 2021-04-29
• Study First Submitted QC: 2021-05-07
• Study First Posted: 2021-05-11
• Status Verified: 2023-09
• Study Start: 2023-09-01
• Last Update Submitted: 2023-09-19
• Last Update Posted: 2023-09-21
• Primary Completion: 2023-12-31
• Study Completion: 2024-06-30

Recruitment & Eligibility

• Status: WITHDRAWN
• Sex: All
• Target Recruitment: Not specified

Inclusion Criteria

• A primary care provider that cares for children under the age of 18. This includes physician's assistants, advanced nurse practitioners, residents or fellows, and physicians in pediatrics, internal medicine, and family medicine.
• Must currently be practicing in Central Florida.
• Be able to speak and write in English
• For phase two of the study an additional requirement is that you must have a medical license to practice independently in the state of Florida.

Read More

Exclusion Criteria

• Not a primary care provider who cares for children.
• A pediatric provider who only provides specialty care
• Not able to speak or write in English
• For phase two of study does not have a medical license to practice independenly in the State of Florida.

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard Education plus Coaching	Education plus Coaching	Pediatric Providers in this arm will receive a continuing medical education program on etonogestrel contraceptive implant. Providers in this arm will also receive a tip-sheet on how to manage side effects as well as a number to directly access a specialist who places them if needed.

Primary Outcome Measures

Name	Time	Method
Types of barriers to referral for etonogestrel implant based on questionnaire	6 months	Barriers to recommending and referring adolescent women for etonogestrel contraceptive implant
Number of adolescent women referred	18 months	Number of adolescent women who were referred for etonogestrel contraceptive implant

Secondary Outcome Measures

Name	Time	Method
Categories of knowledge deficit in pediatric providers based on questionaire	6 months	Understanding whether pediatric providers main knowledge deficit around etonogestrel implant is indications, side effects, or decreasing side effects.
Aspects in Coaching that changed pediatric providers' behaviors	18 months	Qualitative analysis on which parts of coaching or standard intervention were most considered in referring.