Cluster randomized trial of a patient-centered contraceptive decision support tool, My Birth Control

Dehlendorf, Christine; Fitzpatrick, Jesse K.; Fox, Edith; Holt, Kelsey; Vittinghoff, Eric; Reed, Reiley; Campora, Maria Paula; Sokoloff, Abby; Kuppermann, Miriam

doi:10.1016/j.ajog.2019.02.015

Cited by 64 publications

(59 citation statements)

References 31 publications

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“…We also emphasize that this study evaluated provider perspectives on the tool, not patient perspectives. However, by gathering different perspectives on the experience of integrating My Birth Control into contraceptive counseling, providers' perspectives reported here and patients' perspectives reported elsewhere [22], we are able to triangulate our findings to increase the trustworthiness of these results. Another limitation of the study is that the study took place at only four sites in a single geographical area that is known for welcoming technology, which limits its transferability to sites outside of this area.…”

Section: Discussionmentioning

confidence: 69%

“…In a cluster randomized controlled trial evaluating My Birth Control, use of the tool was associated with positive impacts on patients' experience of counseling and perception of decision quality [22,23] without increasing patient-facing time for the providers. Together, both quantitative analyses of patient experience reported elsewhere [22] and mixed-method analyses of provider experience demonstrate the tool's efficacy in encouraging a patient-centered, shared decision-making approach to contraceptive counseling without increasing provider burden.…”

Section: Discussionmentioning

confidence: 99%

“…We developed a contraceptive decision support tool, My Birth Control, designed to facilitate the implementation of the best practices of shared decision making in family planning services [21]. Evaluations of the effects and patient satisfaction with the tool are reported elsewhere [22]. Here, we report on how patients' use of the contraceptive decision support tool, My Birth Control, impacts provider experience of contraceptive counseling, including provider resistance and burnout, and influence on appointment time.…”

Section: Introductionmentioning

confidence: 99%

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A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making

et al. 2019

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“…We used attitudinal scales previously developed to assess respondents' overall attitudes towards a range of contraceptive methods, both for themselves and for others their age [21]. For each method they reported having heard of, we asked participants to respond on a scale from 0 ("terrible method") to 10 ("great method") to the following questions: "Overall, how would you rate each of the following as a birth control method for yourself (even if you've never used it)?"…”

Section: Outcomes and Measuresmentioning

confidence: 99%

Birth Control Connect: A randomized trial of an online group to disseminate contraceptive information

et al. 2020

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Objective: We sought to test whether participation in an online group including IUD users influenced IUD-related knowledge, attitudes, and behavior among IUD non-users, as a proof-ofconcept evaluation of information dissemination for less commonly used or novel contraceptives. Study design: We conducted a blinded, randomized controlled trial on the effect of online communication with IUD users within an online program called Birth Control Connect. Participants were women age 18-45 living in the United States who had never used an IUD. We invited participants randomized to the intervention to join two-week, nine-member discussion groups including four satisfied IUD users and five IUD non-users; we invited control participants to groups including nine IUD non-users. We performed chi-squared tests on IUD knowledge, information-seeking, informational support and use in immediate post-surveys, and t-tests comparing change in IUD attitudes and frequency of logins to discussion groups. Results: We invited 488 IUD non-users and enrolled them into 70 groups between October 2015 and April 2016. We found increased positive attitudes towards the IUD in the intervention arm (0.65-point increase between pre-and post-surveys, versus 0.05 mean change for control arm, p = 0.03 for hormonal IUD, with a trend in the same direction for the non-hormonal IUD). Informational support also increased, with 70.3% of intervention arm participants self-reporting that they gained a better idea of what the IUD would be like, compared to 51.

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“…Because male partner awareness and support is likely to play in important role in women's ability to successfully use an HIV prevention product [11,25,26], interventions should target both men and women.…”

Section: Discussionmentioning

confidence: 99%

Acceptability and Feasibility of the CHARISMA Counseling Intervention to Support Women’s Use of Pre-Exposure Prophylaxis

Wilson¹,

Wagner²,

Palanee‐Phillips³

et al. 2020

Preprint

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Background: Women may need or seek male partner approval to {Malow, 2000 #18}{Malow, 2000 #18}{Malow, 2000 #18}{Malow, 2000 #18}safely and consistently use oral antiretroviral pre-exposure prophylaxis (PrEP) or vaginal microbicides. We developed CHARISMA, a counseling intervention to support women’s relationships and their ability to consistently use HIV prevention products.Methods: In a pilot study with 95 female participants in Johannesburg, South Africa, lay counselors assessed participants’ relationship(s) with their male partner(s) and barriers or facilitators to HIV prevention method use, and then provided tailored, interactive counseling. We conducted study participant surveys and clinic staff interviews to evaluate CHARISMA’s feasibility and acceptability.Results: The CHARISMA pilot study indicates that a two-session relationship counseling intervention with 6-month follow-up to support women’s ability to safely and effectively use vaginal microbicides was generally acceptable and feasible. Most participants thought CHARISMA was relevant, helpful, and about the right length, and that it had a positive impact on their relationships with their partners and their product use. Staff stated that it was generally feasible to implement. Based on these promising preliminary findings, the project team is currently conducting a randomized controlled trial in which participants are receive either the standard of care for IPV screening and referral (control arm) or the CHARISMA intervention.Conclusions: Clinic staff felt strongly that the length and intensity of CHARISMA were necessary for participants to begin to trust the counselors enough to be open and honest about problems in their relationships, and to begin to overcome the normalization of intimate partner violence. The length and intensity of CHARISMA may not be feasible in some settings, but a shorter version of the intervention may not offer as much support as women and staff need. One possible approach to reduce the burden on clinic staff would be to self-administer the intervention through a computer rather than requiring a counselor. Lessons learned from the pilot study may be relevant to others developing interventions supporting women’s use of oral PrEP or vaginal microbicides.

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Cluster randomized trial of a patient-centered contraceptive decision support tool, My Birth Control

Cited by 64 publications

References 31 publications

A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making

A mixed-methods study of provider perspectives on My Birth Control: a contraceptive decision support tool designed to facilitate shared decision making

Birth Control Connect: A randomized trial of an online group to disseminate contraceptive information

Acceptability and Feasibility of the CHARISMA Counseling Intervention to Support Women’s Use of Pre-Exposure Prophylaxis

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