Improving LARC Access for Urban Adolescents and Young Adults in the Pediatric Primary Care Setting

Uche F. Onyewuchi, Kathy Tomaszewski, Krishna K. Upadhya, Priya S. Gupta, Natalie Whaley, Anne E. Burke, Maria E. Trent

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The objective of this quality improvement study was to assess the feasibility, acceptability, and impact of integrating long-acting reversible contraceptive (LARC) delivery services into an academic pediatric primary care practice. Adolescent medicine providers in Baltimore, Maryland, were trained in LARC placement with gynecology providers integrated to offer onsite LARC placement and procedural support. Referrals, appointments, and contraceptive method choice/receipt were tabulated. Of 212 individuals referred for LARC consultations, 104 attended appointments. LARC placement at the initial referral increased from year 1 (N = 1) to year 2 (N = 42; P <.01). Adolescent medicine providers placed more LARCs in year 2 (N = 34) than year 1 (N = 0; P <.01). Patients aged 18 to 24 years were less likely to have a LARC placed than those aged 13 to 17 years (unadjusted odds ratio = 0.47 [0.26-0.86]). In conclusion, provider training and service integration of LARC services within a pediatric practice is feasible, acceptable, and increases LARC access and placement.

Original languageEnglish (US)
Pages (from-to)24-33
Number of pages10
JournalClinical pediatrics
Issue number1
StatePublished - Jan 1 2019


  • AYA
  • adolescent and young adult
  • family planning
  • quality improvement

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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