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Implementation of patient-centered contraceptive provision in community settings
Investigator (PI): Madden, Tessa
Performing Organization (PO): (Current): Washington University in St. Louis, School of Medicine, Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology / (314) 362-7139
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2013
Final Year: 2019
Record Source/Award ID: PCORI/CD-12-11-4586
Funding: Total Award Amount: $1,766,573
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: More than three million pregnancies each year are unintended or unplanned-this means that the pregnancy is unwanted or the timing is wrong. Unplanned pregnancy contributes to poor health outcomes for women and children. Contraception or birth control helps to prevent unplanned pregnancy. Long-acting reversible contraceptive methods such as intrauterine devices (IUDs) and implants are the most effective birth control methods for preventing pregnancy and are more effective than other methods, such as oral contraceptive pills or condoms. However, long-acting birth control is used less commonly in the United States than pills and condoms. If more women used long-acting contraception, this would likely lead to fewer unplanned pregnancies. We are not sure how best to increase the use of these long-acting methods. Contraceptive counseling may help. The Contraceptive CHOICE Project (CHOICE) is a research study of more than 9,000 women who were provided with birth control at no cost. The study was designed to increase the use of long-acting contraception and reduce unplanned pregnancy. All women received contraceptive counseling that discussed all reversible birth control options. Seventy-five percent of women in the study chose an IUD or an implant and were much less likely to have an unplanned pregnancy. Objective: Our overall goal is to reduce unintended pregnancy. In this study, we plan to apply our results from CHOICE into the real world. We suspect that contraceptive counseling alone is not enough to increase use of long-acting contraception. This is because factors such as cost and health care provider misconception may make it difficult for women to get IUDs and implants. We think that contraceptive counseling is important, but cost may prevent many women from obtaining the birth control methods that they want. Method: The proposed project would compare two different ways of providing contraception in community health care clinics. In the first, patients will receive contraceptive counseling that talks about all birth control methods. They will also have a visit with their health care provider. In the second, patients will receive the same contraceptive counseling. They will also have a visit with their health care provider, who will have had special training in long-acting contraception. They will also receive help paying for a long-acting method if they do not have health insurance or their insurance does not cover the method. Women who participate in this study will provide information by completing surveys. They will complete a survey after their visit with their health care provider and six weeks, six months, and 12 months later. We will then compare how many women have an unplanned pregnancy between the two groups. We will also look at what birth control method women chose, how happy they were with counseling about birth control, how happy they were with the clinic visit, and whether they keep using their birth control method.
MeSH Terms:
  • Community Health Services /*organization & administration
  • Contraception /*methods
  • Contraceptive Agents /*therapeutic use
  • Female
  • Health Care Costs
  • Humans
  • Intrauterine Devices
  • Outcome Assessment, Health Care
  • Patient Education as Topic
  • Patient Participation
  • Patient Preference
  • Patient-Centered Care
  • United States
Country: United States
State: Missouri
Zip Code: 63110
UI: 20143225
CTgovId: NCT02364037
Project Status: Completed
Record History: ('2019: Project end date corrected to 2019 per PCORI.\n2017: Project extended to 2018.\n',)