Introduction The increased use of long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormonal implants, has the potential to reduce unintended pregnancy and abortion rates. However, use of LARCs in Australia is very low, despite clinical practice guidance and statements by national and international peak bodies advocating their increased use. This protocol paper describes the Australian Contraceptive ChOice pRojet (ACCORd), a cluster randomised control trial that aims to test whether an educational intervention targeting general practitioners (GPs) and establishing a rapid referral service are a cost-effective means of increasing LARC uptake.
Methods and analysis The ACCORd intervention is adapted from the successful US Contraceptive CHOICE study and involves training GPs to provide ‘LARC First’ structured contraceptive counselling to women seeking contraception, and implementing rapid referral pathways for LARC insertion. Letters of invitation will be sent to 600 GPs in South-Eastern Melbourne. Using randomisation stratified by whether the GP inserts LARCs or not, a total of 54 groups will be allocated to the intervention (online ‘LARC First’ training and rapid referral pathways) or control arm (usual care). We aim to recruit 729 women from each arm. The primary outcome will be the number of LARCs inserted; secondary outcomes include the women's choice of contraceptive method and quality of life (Short Form Health Survey, SF-36). The costs and outcomes of the intervention and control will be compared in a cost-effectiveness analysis.
Ethics and dissemination The ACCORd study has been approved by the Monash University Human Research Ethics Committee: CF14/3990-2014002066 and CF16/188-2016000080. Any protocol modifications will be communicated to Ethics Committee and Trial Registration registry. The authors plan to disseminate trial outcomes through formal academic pathways comprising journal articles, nation and international conferences and reports, as well as using more ‘popular’ strategies including seminars, workshops and media engagements.
Trial registration number ACTRN12615001346561.
- Long Acting Reversible Contraceptives (LARCs)
- General Practitioners
- Cluster randomised controlled trial
- Complex interventions
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Contributors DM has led the development of this proposal. DM, KB, AT, JL, KM, MH and JFP were involved with developing the study protocol, design (adapted from the US Contraceptive CHOICE study) and funding proposal. KM provided the support for the development of the statistical analyses plan. DM, KB, AT, JL, KM, MH, HM and JFP have been involved with reviewing and editing the manuscript and have read and approved the final version.
Funding ACCORd is funded by the National Health and Medical Research Council—NHMRC grant ID: 1081743.
Competing interests None declared.
Ethics approval Ethics approval and consent to participate phase 1 of the study (the recruitment and training of GPs) and phase 2 of the study (the recruitment of women) have been approved by the Monash University Human Research Ethics Committee: CF14/3990-2014002066 and CF16/188-2016000080.
Provenance and peer review Not commissioned; externally peer reviewed.
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