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N/A N=786 Randomized Other

Patient-Centered Support for Contraceptive Decision-Making

Contraception · Contraceptive Behavior

Enrolled (actual)
786
Serious AEs
0.0%
Results posted
Nov 2018
Primary outcome: Primary: Contraceptive Continuation — 201; 174; 154; 118 Participants — p=0.46

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Contraceptive Decision Support Tool (Behavioral)
Age
Pediatric, Adult · 15+ yrs
Sex
Female
Sponsor
University of California, San Francisco
Primary completion
Oct 2016

Outcome Measures

OutcomeResultp-value
PRIMARY
Contraceptive Continuation
201; 174; 154; 118; 49; 53 0.46
SECONDARY
Patient Contraceptive Counseling Satisfaction
261; 194; 133; 143; 10; 8 0.03 sig
SECONDARY
Patient Satisfaction With Information Received About Side Effects During Counseling
325; 253; 64; 81; 15; 11 0.01 sig
SECONDARY
Overall Satisfaction With Visit
338; 282; 56; 54; 10; 9 0.62
SECONDARY
Shared Decision Making - Feelings About Provider Involvement
370; 305; 8; 10; 16; 21 0.85
SECONDARY
Shared Decision Making - Provider Appropriately Expressed Preference
16; 13; 357; 297; 21; 26 0.997
SECONDARY
Shared Decision Making - Satisfaction With How Provider Helped With Choice
303; 240; 91; 96; 10; 9 0.13
SECONDARY
Shared Decision Making - Who Made the Decision?
286; 244; 20; 9; 88; 83 0.50
SECONDARY
Shared Decision Making - Provider Preference
194; 143; 200; 193; 10; 9 0.12
SECONDARY
Patient Decisional Conflict in Contraceptive Choice
100; 76; 294; 260; 10; 9 0.41
SECONDARY
Patient Knowledge of Contraceptive Options and Features
220; 170; 174; 166; 10; 9 0.12
SECONDARY
Patient Chosen Contraceptive Method Satisfaction
249; 199; 145; 137; 10; 9 0.25
SECONDARY
Patient Current Contraceptive Method Satisfaction
209; 177; 147; 113; 48; 55 0.55
SECONDARY
Patient Attitude Towards Use of Contraceptive Options
6.26; 6.55; 5.22; 5.4; 5.07; 5.49 0.13
SECONDARY
Newly Heard About Methods During Visit
79; 46; 21; 18; 304; 281 0.27
SECONDARY
Patient Rating of Visit as "Much Better" Than Previous Family Planning Visit
142; 104; 144; 140; 118; 101 0.18
SECONDARY
Total Clinic Visit Time
98.40; 86.94 <0.001 sig
SECONDARY
Time Spent With Contraceptive Counseling Provider
44.0; 44.4 0.63
SECONDARY
Maslach Burnout Inventory
-2.27; 1.07; -0.87; 0.46; -0.80; 2.38 0.24

Summary

The investigators have designed a tablet-based decision support tool to help women learn more about their birth control options and support them in choosing a method they are happy with. The investigators will test whether the decision support tool helps women choose a birth control method they can continue using successfully by having some women use the tool before their birth control-related visit to a health care provider, and some women not use the tool before their visit. The investigators will then follow up with all the women at four months and seven months after their visit to see if they are still using the birth control method they chose at the visit and how happy they are with the method. Hypotheses: 1. Women who use the contraceptive decision support tool will be more likely to continue using their chosen method at 4 and 7 months follow-up, compared to women who receive usual care. 2. The contraceptive decision support tool will increase women's knowledge, choice of, and use of highly effective reversible contraception, compared to usual care. 3. The contraceptive decision support tool will decrease decision conflict, compared to usual care. 4. The contraceptive decision support tool will increase patient satisfaction with the clinic visit and with their method, compared to usual care. 5. Women who use the contraceptive decision support tool will have fewer unintended pregnancies during the follow-up period, compared to women who received usual care. 6. The contraceptive decision support tool will increase shared patient-provider decision making in contraceptive counseling visits, compared to usual care. 7. The contraceptive decision support tool will decrease provider frustration when providing contraceptive counseling and increase provider job satisfaction. 8. Women using the tool will be more likely to report use of any moderately or highly effective method of contraception at 4 and 7 months follow-up, compared to women not using the tool.

Eligibility Criteria

Inclusion Criteria

Patients

  • Women of reproductive age (15-45)
  • Wish to discuss starting or changing a contraceptive method during their visit
  • Speak, read, and understand English or Spanish (Note: for the pre- and post-intervention audio recording phases, only patients who can speak, read, and understand English easily will be enrolled.)
  • History of sexual activity with men

Providers

  • Provide contraceptive counseling in one of the participating clinics
  • Plan to remain in job role for at least six months

Clinic staff

  • Work at one of the participating clinics
  • Had a job that included patient contact, but did not solely consist of family planning counseling at the time of the implementation of the intervention

Exclusion Criteria

Patients

  • Previously enrolled in the study
  • Previously used the decision support tool at the Women's Community Clinic in San Francisco
  • Are unable to get pregnant
  • Appointment reason is for insertion of IUD or contraceptive implant
  • Currently pregnant
  • Desire pregnancy currently or in the next seven months (Note: The last criterion is designed to ensure we will have limited numbers of women that will discontinue their contraceptive methods during the study due to planning a pregnancy.)
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02078713). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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