Contraceptive Equity Study 2016

Study Overview
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Brief Summary
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The purpose of this study is to assess the impact of a provider counseling training on patient contraceptive behaviors and satisfaction in a clustered randomized trial among 10 Planned Parenthood health centers.

Detailed Description
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This study builds upon prior research on a contraceptive counseling protocol and training developed and studied by partners at New York University and Planned Parenthood Federation of America. This contraceptive counseling protocol is informed by the literature on contraceptive behavior, expertise in decision and communication science, and formative qualitative research with Planned Parenthood providers and patients. Jaccard et al. (in press) conducted a cluster randomized control study of the counseling intervention with 10 Planned Parenthood health centers, where staff at intervention sites participated in a one-day training on the counseling protocol followed by a day of in-clinic shadowing. Patients were enrolled on-site and contacted for follow-up at six months and 12 months. Results of this study indicated that patients at intervention sites were more satisfied with their contraceptive counseling and method choice, and at one or both follow-ups there were fewer gaps in contraceptive protection, more dual method use, and less non-use of birth control. There was no significant difference in accurate use of birth control pills. Planned Parenthood Federation of America (PPFA) adapted and piloted training in this contraceptive counseling protocol during 2016 with 18 Planned Parenthood affiliated organizations across the country. This training was integrated into a one-day event that also included a provider training to address barriers in access to intrauterine devices and implants. A mixed-methods implementation evaluation was conducted to assess outcomes for staff and patients and identify challenges in implementation. Preliminary findings from the program pilot year demonstrated positive trends for outcome measures, produced lessons learned on implementation challenges, and provided support for new adaptations to the training program and counseling protocol. The previous pilot year evaluation was designed to assess patient satisfaction and method choice before and after the training, but could not answer questions about continued impact on other outcomes of interest. The current study will use a cluster randomized control design with 10 Planned Parenthood health centers to assess patient outcomes. Five health centers randomized to the intervention will receive the contraceptive counseling training. As the control group, the other five health centers will conduct usual care. Women will be enrolled onsite at the health center and then contacted for follow-up at approximately 30 and 90 days post-enrollment. Target enrollment is 100 women per site (1000 total).

Official Title
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Contraceptive Equity Study

Conditions
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Contraception Behavior, Contraceptive Usage, Contraceptive Method Switching

Intervention / Treatment
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* Behavioral: Contraceptive Counseling Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Females who have received contraceptive counseling at participating health centers. Ability to understand written and spoken English. Exclusion Criteria: Non-English speakers
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Arm<br>Full-day contraceptive counseling training for health center staff | Behavioral: Contraceptive Counseling Training<br>* Intervention sites will receive: In person training: All staff at an intervention health center will participate in a one-day counseling training. On-site shadowing: Trainers will shadow staff in-clinic the day following the training to observe the counseling implementation and provide additional coaching and support. Technical assistance: A Planned Parenthood clinic operations expert will provide follow-up technical assistance.<br>|
| No Intervention: Control Arm<br>Usual care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Contraceptive Continuation | Patient-reported contraceptive continuation | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Method Satisfaction | Patient-reported satisfaction with contraceptive method | 1 month and 3 months | 
| Dual-Use | Patient-reported dual-use of condoms plus other method | 1 month and 3 months | 
| Missed Pills | Number of patient-reported missed oral contraceptive pills among pill users | 1 month and 3 months | 
| Method Switching | Patient-reported method switching | 1 month and 3 months | 
| Patient experience of counseling best practices during their visit | Patient-report of staff implementation of the best counseling practices during their visit | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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contraceptive counseling, cluster randomized trial, provider counseling training