The ORIENT Study

Improving rural and regional access to long-acting reversible contraception and medical abortion through nurse-led models of care, task-sharing and telehealth 

 
Project Manager: Dr Jessica Botfield
Project team: Ms Mae Rilloraza
 
Australian women living in rural and regional areas experience many barriers to accessing long-acting reversible contraception (LARC) and early medical abortion (EMA) services.
 
ORIENT (ImprOving Rural and regIonal accEss to long-acting reversible contraceptioN and medical abortion through nurse-led models of care, Tasksharing and telehealth) is a stepped-wedge pragmatic cluster-randomised controlled trial which aims to assess the effectiveness of a nurse-led model of care in general practice at increasing uptake of LARC and improving access to medical abortion in rural and regional areas.
 
The nurse-led model of care was co-designed with consumers and women’s health professionals, ensuring that the intervention can meet consumer needs, is evidence-based, feasible, sustainable and offers the best chance of success. Practices were randomised to implement the model sequentially, with the comparator being usual care. All practices received implementation support including:
  • Free online accredited LARC and EMA training
  • An online educational outreach session to discuss practical strategies for implementing the nurse-led model, tailored to each practice
  • Enrolment into the AusCAPPS Network, an Australia-wide virtual community of practice that connects EMA and LARC providers through peer-networking opportunities and access to resources and training
  • Reimbursement and continuing professional development points

 We are in the final phases of the study and are currently undertaking the process evaluation and health economic evaluation (2025/26).

This project is supported by the Medical Research Future Fund.

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Recruitment for this study has closed

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Publications

ORIENT stepped wedge trial statistical analysis plan

Kasza J, Grantham K, Botfield J, Mazza D, Rilloraza M.

Monash University. 2025 May. https://doi.org/10.26180/28953290.v2

An Acceptability and Feasibility Study of a Nurse-Led Model of Contraception and Abortion Care in Rural General Practice

Moulton J, Botfield J, Arefadib N, Freilich K, Mazza D.

Journal of advanced nursing. 2025 Jan 22. doi: 10.1111/jan.16777. Online ahead of print.

A nurse-led model of care to improve access to contraception and abortion in rural general practice: Co-design with consumers and providers

Moulton J, Arefadib N, Botifeld J, Freilich K, Tomnay J, Bateson D, Black K, Nornman W, Mazza D. 

Journal of advanced nursing. 2025 Feb;81(2):1019-1037. doi: 10.1111/jan.16299. Epub 2024 Jul 2.

Nurse and midwife involvement in task-sharing and telehealth service delivery models in primary care: A scoping review

Moulton J, Botifled J, Subasinghe A, Withanage N, Mazza D. 

Journal of clinical nursing. 2024 Aug;33(8):2971-3017. doi: 10.1111/jocn.17106. Epub 2024 Mar 18.

Co-design of a nurse-led model of care to increase access to medical abortion and contraception in rural and regional general practice: A protocol

Moulton J, Mazza D, Tomnay J, Bateson D, Norman W, Black K, Subasinghe A. 

Aust J Rural Health. 2022 Dec; 30(6): 876-883.

Nurse-led service delivery models in primary care: a scoping review protocol

Moulton J, Withanage N, Subasinghe A, Mazza D. 

BMJP Open. 2022 Sept; 6(3): BJGPO.2021.0194.

Practice nurse provision of early medical abortion in general practice: opportunities and limitations

Moulton J, Subasinghe A, Mazza D. 

Aust J Prim Health. 2021 Dec;27(6): 427-430.