Using the Healthcare Visit to Improve Contraceptive Use
Condition: Pregnancy; Chlamydia
MeSH terms: Chlamydia Infections
Study type: Interventional

Summary: 
      Consistent and correct use of an effective contraceptive method is a primary determinant in
      preventing pregnancy. Unfortunately, only a minority of healthcare providers adequately
      address women's contraceptive needs. We have developed a standardized behavioral-based
      contraceptive counseling model that can be used by providers and other clinic staff to
      address this limitation. The model, ESP, is an adaptation of motivational interviewing and
      involves: Exploring discrepancies between pregnancy intention and contraceptive use and
      between risk of STDs and condom use; Sharing information; and Promoting behaviors to reduce
      risk.

      Study question: Does ESP counseling lead to an increase in consistency and effectiveness of
      contraceptive use among women at risk of unintended pregnancy?

      Methods: Randomized controlled trial of 747 women, ages 16-44, at self-identified risk of
      unintended pregnancy enrolled from March 2003 to September 2004 at healthcare settings in
      North Carolina. Intervention participants received individualized ESP counseling from a
      health educator to address barriers to effective and consistent contraceptive use. Risk
      reduction steps were negotiated. Pregnancy, Chlamydia infection and contraceptive use were
      assessed at baseline and follow-up. "Highly effective" contraceptive use was defined as a
      combination of effectiveness and consistency. Women in the control arm received general
      preventive health counseling (e.g., smoking and exercise). Differences between the study arms
      at 12-months may illustrate the longer term influence of the intervention.
    

Detailed description: 
      Consistent and correct use of an effective contraceptive method is a primary determinant in
      preventing pregnancy. Unfortunately, only a minority of healthcare providers adequately
      address women's contraceptive needs. We have developed a standardized behavioral-based
      contraceptive counseling model that can be used by providers and other clinic staff to
      address this limitation. The model, ESP, is an adaptation of motivational interviewing and
      involves: Exploring discrepancies between pregnancy intention and contraceptive use and
      between risk of STDs and condom use; Sharing information; and Promoting behaviors to reduce
      risk.

      Study question: Does ESP counseling lead to an increase in consistency and effectiveness of
      contraceptive use among women at risk of unintended pregnancy?

      Methods: Randomized controlled trial of 747 women, ages 16-44, at self-identified risk of
      unintended pregnancy enrolled from March 2003 to September 2004 at healthcare settings in
      North Carolina. Intervention participants received individualized ESP counseling from a
      health educator to address barriers to effective and consistent contraceptive use. Risk
      reduction steps were negotiated. Pregnancy, Chlamydia infection and contraceptive use were
      assessed at baseline and follow-up. "Highly effective" contraceptive use was defined as a
      combination of effectiveness and consistency. Women in the control arm received general
      preventive health counseling (e.g., smoking and exercise). Differences between the study arms
      at 12-months may illustrate the longer term influence of the intervention.
    

Intervention name(s): Contraceptive counseling
Intervention type(s): Behavioral
Intervention MeSH terms: Contraceptive Agents
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single
Primary purpose: Educational/Counseling/Training