Training at school-based health centers to improve access to comprehensive contraceptive services

Many pediatric providers are not trained to adequately provide comprehensive counseling and the full range of birth control methods to adolescents. Access to comprehensive contraceptive counseling can better empower adolescents to select their preferred method. School-based health centers are often the first interaction many adolescents have with the health care system. Providing contraceptive services through these centers can increase access to comprehensive and non-stigmatizing health services. 

Various contraceptive methods

Researchers from Beyond the Pill at the Bixby Center built upon their previous contraceptive training research to adapt and evaluate their training at school-based health centers. Their new research explores whether this training makes providers more likely to offer students patient-centered contraceptive counseling and the full range of contraceptive methods, including long-acting reversible contraceptives like IUDs and implants. The training was informed by an equity framework, focusing on ethical issues specific to offering long-acting reversible contraceptives. The training emphasized the importance of patients’ reproductive autonomy, issues around coercion and provider bias, and the importance of removing a method immediately upon patient request.

The training resulted in significant improvements in provider knowledge, counseling skills and competency providing IUDs and implants. Previous studies have shown that up to 61-69% of adolescents would prefer using long-acting reversible contraceptives. Increasing access to preferred methods is an important component of respecting patients’ reproductive autonomy. However, it is vital to emphasize patient preferences and ensure that one’s choice of a birth control method is voluntary.

These findings highlight that this evidence-based training is an effective way to improve adolescents’ access to full contraceptive services. This is especially important in the current environment, with increasingly restrictive policies on contraceptive services and sexual education for adolescents, and decreased access to clinic services due to the COVID-19 pandemic. In the future, this training can be scaled and replicated across school-based health centers to enable a wider range of adolescents to have access to all contraceptive methods.