Computer-assisted Preventive Health Education for Women of Reproductive Age in Urgent Care Settings
Condition: Preconception Care
Study type: Interventional
Phase: Phase 3

Summary: 
      The purpose of this study is to determine whether "video doctor" programs can effectively
      deliver preventive health messages to women of reproductive age while they wait to be seen in
      urgent care settings. In this study, the specific hypotheses being tested are: 1) is the
      video doctor program effective in improving women's knowledge about emergency contraception,
      and 2) is the video doctor program effective in improving women's knowledge about the
      importance of folate.
    

Detailed description: 
      We will randomly assign participants to interact with one of two "video doctor" programs
      which have been been developed to convey messages appropriate for women of reproductive age.

      The "video doctor" is an actress (not UCSF staff) following a script that has been designed
      through interdisciplinary collaboration here at UCSF. These particular video programs have
      not been used before, but similar ones have been studied and shown to be effective by Dr.
      Gerber in providing patients with information about how to decrease sexual risks and the
      harms of alcohol and drug use. Before interacting with the "video doctor" program, we will
      assess participants baseline knowledge of the importance of peri-conception folate and the
      option of emergency contraception. Participants will then interact with their "video doctor"
      and be provided with a free sample of the pills their video doctor discussed.

      The first "video doctor" will educate women about the ability of folate to reduce birth
      defects. The discovery that peri-conception folate supplementation significantly decreases
      rates of neural tube defects has inspired multiple educational campaigns. However, recent
      work has shown that knowledge of the benefits of folate remains low, especially among
      minority populations.

      The second "video doctor" message will inform women of the option of emergency contraception.
      Emergency contraception using high doses of progesterone has been shown to reduce the risk of
      pregnancy to less than 2% when used up to five days after a condom failure or an episode of
      unprotected sex.

      This medication is not teratogenic and will not cause a miscarriage if used by a woman who
      does not know she is pregnant. Use of emergency contraception poses no long-term health risks
      to women and is available over-the-counter in seven European countries. Prior studies in
      family planning clinics , as well as the post-partum setting have shown that education about
      and advance provision of emergency contraceptive pills can increase knowledge and appropriate
      use of these pills, without adversely affecting sexual risk taking or other health behaviors.
      However, knowledge of emergency contraception remains limited, leading some to call it
      America's "best kept secret." Participants will be contacted by phone six months after
      interacting with the "video doctor" and asked to provide information about their use of
      folate and/or emergency contraception. One year after interacting with the "video doctor"
      participants will be contacted again and asked to provide further information about their use
      of folate and/or emergency contraception.
    

Intervention name(s): "video doctor," computer module
Intervention type(s): Behavioral
Intervention description(s): computerized counseling about emergency contraception and peri-conception folate
Other intervention name(s): EC and folate arms
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Keywords: emergency contraception; folic acid; education; preventive health