PC2002: Customizing Contraception Education: Assessing Community Pediatrician and Pediatric Resident Knowledge and Acceptability of AAP Contraception Guidance in Primary Care at a Single Coastal Children’s Health Care System

Purpose/Objectives: With close to half of US high school students reporting having had sexual intercourse and approximately 750,000 adolescents becoming pregnant each year, the United States boasts the highest rate of teenage pregnancy among other high-income countries. The AAP Committee on Adolescence affirmed the role of the pediatrician in reproductive health for adolescents, releasing guidance on sexual and reproductive healthcare services in the pediatric setting. We aimed to assess AAP guidance on contraception knowledge and comfort prescribing among community pediatricians and pediatric residents, in order to customize a curriculum to increase implementation of contraceptive teaching and prescriptions in the pediatric resident clinic.

Design/Methods: An anonymous questionnaire was distributed across the academic and community pediatric practices among both attendings and pediatric residents. The questionnaire was designed to assess the knowledge, experiences, comfort, perceived barriers and willingness to prescribe contraception to adolescent and young adult menstruators from current guidelines. Data was collected anonymously over the course of several weeks and categorical results are shown as percentages.

Results: Of the 100 general pediatricians who received the questionnaire, 44 responded to the survey (44%). 29.5% stated they had not prescribed any hormonal contraception in the 6 months prior to taking the survey. The most common reason for not prescribing hormonal contraception was lack of knowledge (45%). Of the 70 pediatric residents who received the questionnaire, 39 responded (55.7%). From those responding, 84.6% reported never prescribing short-acting hormonal birth control and 100% has never prescribed long-acting hormonal control. Overwhelmingly, residents are interested in improving their knowledge of contraception, with 94.9% stating they wanted more education on this topic. Residents identified that the majority of education regarding contraception was from their adolescent medicine rotation (48.7%), followed by the internet (25.6%), with only 10.3% of residents identifying their primary care clinic as a source of contraception education.

Conclusion/Discussion: General pediatricians are in a unique position of having long-term relationships with patients and their families. The AAP recommends that general pediatricians should “counsel and ensure access to a broad range of contraceptive methods, including educating their patients.” However, as our data suggests, not all pediatricians are current with AAP guidelines and residents are not all getting equal education. Our pediatric residents are receiving the majority of this education outside of their primary care clinics, without the opportunity to prescribe and manage contraception. Additionally, general pediatricians may not be routinely prescribing hormonal contraception due to the lack of knowledge provided by the guidelines. A curriculum is being developed based on our needs assessment to ensure that evidence-based and comprehensive information is available for current pediatric residents and general pediatricians.