Preconception Care Clinical Trial
Official title:
Preventive Health Education for Women of Reproductive Age
The purpose of this study is to determine whether "video doctor" programs can effectively deliver preventive health messages to women of reproductive age while they wait to be seen in urgent care settings. In this study, the specific hypotheses being tested are: 1) is the video doctor program effective in improving women's knowledge about emergency contraception, and 2) is the video doctor program effective in improving women's knowledge about the importance of folate.
We will randomly assign participants to interact with one of two "video doctor" programs
which have been been developed to convey messages appropriate for women of reproductive age.
The "video doctor" is an actress (not UCSF staff) following a script that has been designed
through interdisciplinary collaboration here at UCSF. These particular video programs have
not been used before, but similar ones have been studied and shown to be effective by Dr.
Gerber in providing patients with information about how to decrease sexual risks and the
harms of alcohol and drug use. Before interacting with the "video doctor" program, we will
assess participants baseline knowledge of the importance of peri-conception folate and the
option of emergency contraception. Participants will then interact with their "video doctor"
and be provided with a free sample of the pills their video doctor discussed.
The first "video doctor" will educate women about the ability of folate to reduce birth
defects. The discovery that peri-conception folate supplementation significantly decreases
rates of neural tube defects has inspired multiple educational campaigns. However, recent
work has shown that knowledge of the benefits of folate remains low, especially among
minority populations.
The second "video doctor" message will inform women of the option of emergency
contraception. Emergency contraception using high doses of progesterone has been shown to
reduce the risk of pregnancy to less than 2% when used up to five days after a condom
failure or an episode of unprotected sex.
This medication is not teratogenic and will not cause a miscarriage if used by a woman who
does not know she is pregnant. Use of emergency contraception poses no long-term health
risks to women and is available over-the-counter in seven European countries. Prior studies
in family planning clinics , as well as the post-partum setting have shown that education
about and advance provision of emergency contraceptive pills can increase knowledge and
appropriate use of these pills, without adversely affecting sexual risk taking or other
health behaviors. However, knowledge of emergency contraception remains limited, leading
some to call it America's "best kept secret." Participants will be contacted by phone six
months after interacting with the "video doctor" and asked to provide information about
their use of folate and/or emergency contraception. One year after interacting with the
"video doctor" participants will be contacted again and asked to provide further information
about their use of folate and/or emergency contraception.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Caregiver, Investigator, Outcomes Assessor)
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