LARC use among urban, low-income women
Awarded 2012
Trainee Grants
Charlene Collier, MD, MPH
Yale University

Long-acting reversible contraceptive methods (LARC) including intrauterine devices and implants provide highly effective birth-control but are underutilized among low-income women in the US. With higher rates of unintended pregnancies in this population and higher use of less effective contraceptive methods, greater efforts are necessary to address barriers to acceptance and use of effective family planning services including LARC methods. Community based organizations may be able to play a greater role helping women access effective family planning services. Healthy Start provides comprehensive care-coordination and support to mothers from underserved communities. Healthy Start care-coordinators are in a unique position to establish long-term relationships with participants, understand their motivations and barriers to family planning and help them effectively access services. There is limited research about how Healthy Start can impact women’s knowledge, access, and use of LARC methods. Our study uses community based participatory research involving New Haven Healthy Start (NHHS) to assess LARC acceptance and use in an urban, low-income population. The research team involves NHHS care-coordinators and participants, clinicians and mixed-methods researchers to complete four study components: 1) a survey on LARC use among medical providers of low-income women in New Haven, CT, 2) in-depth interviews about care-coordinators’ perspectives on family planning 3) a survey of NHHS participants’ knowledge and acceptance of LARC and 4) develop and assess a comprehensive strategy to strengthen NHHS family planning efforts. As Healthy Start has locally based sites across the US, the findings of this research could translate to a wide network of providers, care coordinators and women of low-income and minority communities and strengthen the capacity of Healthy Start to help women prevent unintended pregnancies.