Improving Preconception Health through Enhanced Education of Health Care Providers on Long Acting Reversible Contraception (LARC)


young adult in exam roomThe aim of this project is to increase the utilization of long-acting, reversible contraception (LARC) before and between pregnancies in order to decrease unintended pregnancies and poor birth outcomes. VCHIP is collaborating with the March of Dimes and the Vermont Department of Health to provide state-wide outreach and education to increase providers' knowledge of LARC options and guidelines and provide training on education and counseling patients to increase utilization of LARC in Vermont. The project will identify gaps between the latest guidelines and recommendations on LARC and current knowledge and practice ardoun the state and narrow this gap by education Vermont health care providers about these contraceptive methods.

The LARC project is part of the efforts of the Vermont Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality, which formed in 2014 to develop and implement a state-wide plan to reduce infant mortality. One of the strategic priorities of this group is to enhance the quality of care for women before and between pregnancies by increasing the use of LARC in Vermont.


  • To gain an understanding of current practices in the use of LARC, and to ascertain educational needs of providers throughout Vermont
  • Increase knowledge of VT providers on current guidelines and best practices around LARC, as well as on strategies to increase LARC uptake in practices.


  • Developed a LARC needs assessment survey that was distributed to health care providers throughout Vermont
  • Analyzed the results of this survey, and created a report of findings
  • Presented a poster on the results of the needs assessment at the March of Dimes Prematurity Prevention Conference, November 2015
  • Used the findings from the needs assessment survey to create the content for three webinars:


  • Webinar 1: LARC 201: Update on Long Acting Reversible Contraception
    • Speaker: Elisabeth Wegner, MD, Associate Professor, University of Vermont College of Medicine
    • Learning Objectives
      • Incorporate the most recent ACOG and AAP recommendations on LARC's into practice
      • Compare the clinical effects, characteristics and side effects of LARC methods
      • Determine the eligibility of patients for LARC methods using the CDC Medical Eligibility Criteria
  • Webinar 2: Addressing Insurance, Systems and Practice Barriers to LARC Usage
    • Speakers: Katherine Mariani, MD, Assistant Professor, University of Vermont College of Medicine, Therese Fitzgerald, PhD, MSW, Director, Women's Health Policy & Advocacy Program, Connors Center for Women's Health and Gender Biology, Brigham & Women's Hospital
    • Learning Objectives
      • Determine birth control coverage and reimbursement of LARC methods under the Affordable Care Act
      • Identify key approaches to integrating LARCs into primary care practice
  • Webinar 3: Contraceptive Counseling Techniques and LARC Referrals
    • Speaker: Erica Gibson, MD, Assistant Professor, University of Vermont College of Medicine
    • Learning Objectives
      • Determine components of comprehensive LARC counseling
      • Integrate tiered-effectiveness counseling into contraceptive counseling approach
      • Create steps to promote seamless referrals for LARC insertion
  • Presented two in-person contraceptive counseling training's, focusing on LARC.
  • Wednesday May 11, 2016 at the Capitol Plaza Hotel in Montpelier, VT


  • Wednesday June 22, 2016 at the University of Vermont in Burlington, VT
    • Speaker: Donna Burkett, MD, Medical Director, Planned Parenthood of Northern New England
    • Learning Objectives:
      • Apply Reproductive Life Planning concepts to patients presenting for reproductive and sexual health care, as well as broader care, including acute and chronic illnesses
      • Understand the US Medical Eligibility Criteria for Contraceptive Use, integrate them into practice, and be able to apply them to individual cases
      • Utilize a contraceptive counseling approach that is tiered by efficacy, assuring that patients are also educated as to safety and side effects
    • Nexplanon insertion training by Merck

Project Contact

Adrienne Woike, MS, RN, WHNP