Contraceptive Usage Clinical Trial
Official title:
Contraceptive Equity Study
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.
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).
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