A Cluster Randomized Controlled Trial of the MyFamilyPlan Online Preconception Health Education Tool

Abstract

To evaluate whether exposure to MyFamilyPlan-a web-based preconception health education module-changes the proportion of women discussing reproductive health with providers at well-woman visits. Design: Cluster randomized controlled trial. One hundred thirty participants per arm distributed among 34 clusters (physicians) required to detect a 20% change in the primary outcome. Setting: Urban academic medical center (California). Participants: Eligible women were 18 to 45 years old, were English speaking, were nonpregnant, were able to access the Internet, and had an upcoming well-woman visit. E-mail and phone recruitment between September 2015 and May 2016; 292 enrollees randomized. Intervention: Intervention participants completed the MyFamilyPlan module online 7 to 10 days before a scheduled well-woman visit; control participants reviewed standard online preconception health education materials. Measures: The primary outcome was self-reported discussion of reproductive health with the physician at the well-woman visit. Self-reported secondary outcomes were folic acid use, contraceptive method initiation/change, and self-efficacy score. Analysis: Multilevel multivariate logistic regression. Results: After adjusting for covariates and cluster, exposure to MyFamilyPlan was the only variable significantly associated with an increase in the proportion of women discussing reproductive health with providers (odds ratio: 1.97, 95% confidence interval: 1.22-3.19). Prespecified secondary outcomes were unaffected. Conclusion: MyFamilyPlan exposure was associated with a significant increase in the proportion of women who reported discussing reproductive health with providers and may promote preconception health awareness; more work is needed to affect associated behaviors.

Assessing the Impact of Online Health Education Interventions From 2010-2020: A Systematic Review of the Evidence

“…Of the 3 cluster randomized studies, 2 were assessed to be low risk of bias 13,14 and one was assessed to be at high risk of bias (Table 1; for full assessments, including rationale, please see Supplementary Table 2). 11 Stassen et al was assessed to be high risk in the domains around the risk of bias from deviations from the intended intervention and measurement of the outcome.…”

“…Participant follow-up periods ranged from 1 week after the intervention to 6 months following the intervention. 11,14 Study population. There was wide variation in the populations assessed by the included studies (Table 1).…”

“…19 Batra et al found that among non-pregnant women aged 18-45 years, the online intervention was associated with an increase in the proportion of women who discussed reproductive health with their providers compared to standard practice, but had no effect on folic acid supplementation or contraception initiation/change. 14 Health outcomes. One study measured a quantifiable health outcome.…”

“…22,27,28 One study assessed women aged 50 or older, 17 one studied women 18 years old, 15 and one evaluated non-pregnant adult women aged 18 to 45 years. 14 The other 7 studies assessed adults. One assessed a general population of adults.…”

“…Intervention. The interventions assessed in the included studies utilized a variety of technologies, including MOOCs, 21,23-25, 30,31,36 e-Health education tools, resources or trainings, 13,14,18,22,33,27,28,34 websites, 11,12,[15][16][17]19,20,35 webinars, 29 web series, 26,37 and university courses (Tables 1 and 2). 32 Many were described as interactive and multimedia, including videos, text, and other media.…”