Innovative Model of Patient-Centered ConTraception
Condition: Contraception; Unintended Pregnancy
Study type: Interventional

Summary: 
      This study is testing models of contraceptive care that were developed as part of the
      Contraceptive CHOICE Project. CHOICE is a prospective cohort study of 9,256 women designed
      to: 1) promote the use of long-acting reversible contraceptive (LARC) methods which include
      interuterine devices (IUD) and subdermal implants; 2) remove financial barriers to
      contraception; 3) evaluate continuation of and satisfaction with reversible methods; and 4)
      reduce unintended pregnancies in the St. Louis region. CHOICE demonstrated that interventions
      such as comprehensive contraceptive counseling, increased access, and removal of financial
      barriers increase the uptake of LARC methods and reduce unintended pregnancy. The
      investigators objective is to determine whether the CHOICE model of contraceptive care can be
      equally successful in the real world of community clinics.
    

Detailed description: 
      This project involves comparing two models of contraceptive care; 'enhanced care' which is
      usual care plus the CHOICE structured contraceptive counseling, and the 'complete CHOICE'
      group which includes the structured contraceptive counseling as well as provider training and
      cost support for IUDs and implants. Participants will be enrolled at three partner community
      clinics by a staff member (site coordinator) dedicated to the research study. All
      participants will undergo contraceptive counseling as well as a baseline survey with the
      coordinator. Participants will complete telephone surveys at 3, 6, and 12 months
      post-enrollment and will be asked about contraceptive method chosen, satisfaction and
      continuation of the method, and any pregnancies experienced since enrollment.
    

Intervention name(s): CHOICE Project Structured Contraceptive Counseling; Contraceptive Education Session; Cost Support for IUDs and implants
Intervention type(s): Behavioral; Behavioral; Device
Intervention description(s): Women in both phases of the study will receive the structured contraceptive counseling developed by the Contraceptive CHOICE Project.; Prior to Phase 2, health care providers at the recruitment sites will undergo a contraceptive education session with a focus on evidence-based provision of contraception including LARC (IUDs and implant) and same-day insertion.; Women in Phase 2 of the study who desire an IUD or implant can receive one through the study at no cost if they do not have insurance coverage. If women have insurance that covers the device, her insurance will be billed for the cost of the device.
Intervention MeSH terms: Contraceptive Agents
Allocation: Non-Randomized
Intervention model: Sequential Assignment
Intervention model description: We used a prospective, controlled time-trend study design, a non-randomized design where outcomes are compared before and after a change in the healthcare setting.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: intrauterine device; subdermal implant; contraceptive counseling