None listed
Conditions
Brief summary
Adapted from the successful US Contraceptive CHOICE study, ACCORd is a cluster randomised control trial of a complex intervention that involves training GPs to provide “Long-Acting Reversible Contraception (LARC) First” structured contraceptive counselling to women seeking contraception and implementing rapid referral pathways to LARC insertion. Participating GPs will be randomly allocated to either the intervention (online ‘LARC First’ training and rapid referral pathways) or control arm (usual care). Participants (women) will be recruited from each arm. We hypothesise that: 1. Women who receive 'LARC First' structured contraceptive counselling are more likely to choose LARCs as their contraceptive method; 2. Improved referral pathways for LARC insertion will facilitate LARC uptake amongst Australian women.
Interventions
The intervention will occur over a duration of 10 months.
a. Training GPs: GPs in the intervention arm will complete a 6 hour interactive online training program about delivering structured contraceptive counselling with an emphasis on the effectiveness of LARCs. The training is an Australian adaption of materials from the 'LARC first' online training site of the successful US Contraceptive CHOICE study. Modules within the training program include:
* The problem of unintended pregnancies
* W
The intervention will occur over a duration of 10 months. a. Training GPs: GPs in the intervention arm will complete a 6 hour interactive online training program about delivering structured contraceptive counselling with an emphasis on the effectiveness of LARCs. The training is an Australian adaption of materials from the 'LARC first' online training site of the successful US Contraceptive CHOICE study. Modules within the training program include: * The problem of unintended pregnancies * What are long-acting reversible contraceptives? * Learn the advantages and disadvantages of available birth control options * Learn how to expedite access to chosen contraceptive * Long-acting reversible contraceptive insertion and removal * Addressing patient and GP concerns * Scenarios depicting the delivery of structured contraceptive counselling The online training module will be available to GPs from March 2016 until December 2016. While it is recommended that GPs complete the training in one session. If required, GPs may pause their training and return to continue the program at a later time. When a GP in the intervention group completes the online training he or she will receive face-to-face training from a project coordinator regarding enrolling patient participants in the study. Additional practice visits, email and telephone support will be available to GPs in the intervention arm, as requested by the GP. To ensure fidelity of the counselling, random visits to GPs in the intervention arm will be conducted and all GPs will be asked to complete a checklist of items related to the counselling they have provided to participating women. b. Facilitating rapid referral to LARC insertion: Rapid referral pathways to study specific LARC insertion clinics will be established for GPs in the intervention arm who do not undertake LARC insertions in their own rooms. GPs will book online appointments for women to have a LARC insertion at a study-specific LARC insertion clinic provided in the rooms of local gynaecologists. Women seeking contraception, or a change in contraceptive method, will be recruited to each arm – they will all be able to choose their preferred method of contraception.
Sponsors
Professor Danielle Mazza
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
GP’s: eligible if they work three or more sessions per week, are based at a computerised practice in Melbourne, Australia, and have a receptionist who can assist with the recruitment of women. Women: eligible if they are aged between 16 - 45 years, have been sexually active with a male partner in the past six months or anticipate sexual activity in the next six months, have not undergone a tubal ligation or hysterectomy, have partner(s) who have not undergone a vasectomy, are not pregnant or have no desire to become pregnant in the next year, are not currently using a contraceptive method or are interested in starting a new, reversible contraceptive method, are proficient in English and are registered with Medicare.
Exclusion criteria
GP’s: participation is restricted to one GP per practice. Women: excluded if aged <16 years or >45 years.
Outcome results
None listed