Effects of a counselling intervention to improve contraception in deprived neighbourhoods: a randomized controlled trial

Díez, Èlia; López, María José; Marí-Dell’Olmo, Marc; Nebot, Laia; Pérez, Glória; Villalbí, Joan R.; Carreras, Ramón

doi:10.1093/eurpub/ckx046

Cited by 11 publications

(14 citation statements)

References 26 publications

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“…In Sweden, contraception counselling usually takes place in a one-on-one meeting, which may be a challenge for migrants from societies that are more collectivist 28. One potential approach to both increasing contraception use and decreasing unintended pregnancies may be to include both women and men in contraception counselling 29. Healthcare providers who counsel migrants have reported that cost and the presence or absence of regular bleeding are two important factors in their choice of contraception methods 30.…”

Section: Discussionmentioning

confidence: 99%

Contraceptive use among migrant, second-generation migrant and non-migrant women seeking abortion care: a descriptive cross-sectional study conducted in Sweden

Iwarsson

Larsson

Gemzell‐Danielsson

et al. 2019

BMJ Sex Reprod Health

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IntroductionThe objective of this study was to compare ever-in life contraception use, use of contraception at current conception, and planned use of contraception after an induced abortion, among three groups of women: migrants, second-generation migrants and non-migrant women, and to compare the types of contraception methods used and intended for future use among the three groups of women.MethodsThe cross-sectional study administered a questionnaire face-to-face to women aged 18 years and older who were seeking abortion care at one of six abortion clinics in Stockholm County from January to April 2015.ResultsThe analysis included 637 women. Migrants and second-generation migrants were less likely to have used contraception historically, at the time of the current conception, and to plan to use contraception after their induced abortion compared with non-migrant women. Historically, non-migrants had used pills (89%) and withdrawal (24%) while migrants had used the copper intrauterine device (24%) to a higher extent compared to the other two groups of women. Both the migrants (65%) and second-generation migrants (61%) were more likely than the non-migrants (48%) to be planning to use long-acting reversible contraception.ConclusionsLower proportions of contraception use were found in migrants and second-generation migrants than in non-migrants. In addition, there were significant differences in the types of contraception methods used historically and intended for future use.

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Section: Discussionmentioning

confidence: 99%

Contraceptive use among migrant, second-generation migrant and non-migrant women seeking abortion care: a descriptive cross-sectional study conducted in Sweden

Iwarsson

Larsson

Gemzell‐Danielsson

et al. 2019

BMJ Sex Reprod Health

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“…The intervention was framed in an urban equity approach strengthening the health and well-being of low income communities and enhancing local community capacity. It was based in evidence [13,14,21] theory [22,23] and a qualitative research [8,15]. The program was led by community health task groups set in the neighbourhoods, linked to service provision care and supportive environments, and provided by NGO and public health workers.…”

Section: Methodsmentioning

confidence: 99%

“…All materials for users were translated and culturally adapted. Contraceptive methods effectiveness and availability, along with tailored counselling was provided in individual sessions in community facilities such as youth centres, libraries and other settings by trained public health nurses or psychologists [29].…”

Section: Methodsmentioning

confidence: 99%

“…In the first decade of this century, Barcelona and other cities in Spain, a country with universal access to publicly funded health care, including family planning services, underwent an increase in AFR (1999: 3.6 per 1000 women 15-19; 2004: 6.8 per 1000 women [15][16][17][18][19] and adolescent abortion rates (1999: 10.9 per 1000 women 15-19; 2004: 16.2 per 1000 women [15][16][17][18][19] [8]. These data were associated with unprecedented increases in economic immigration from developing countries (city immigrant population 2001: 4.9%; 2010: 17.6%) [9]: even though AFR in the city remained relatively low, a closer look revealed unmet needs for information and services, particularly among immigrant communities [10] 15-19; in immigrants from developing countries: 31.9) [11].…”

Section: Introductionmentioning

confidence: 99%

“…After a review of the main literature [13,14] the SIRIAN program, a community brief counselling intervention involving public health and health care services, municipal agencies and community partners, was developed and launched in five deprived neighbourhoods where public audiences had identified action on unplanned pregnancies as a priority. A previous randomized clinical controlled trial and pre-post studies have shown its effects in increases in optimal contraceptive use among adult and adolescent participants [15,16]. The aim of this study is to evaluate the population impact in AFR with a quasiexperimental design, by comparing the changes in intervened and comparison neighbourhoods over 12 years.…”

Section: Introductionmentioning

confidence: 99%

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Impact of a community contraceptive counselling intervention on adolescent fertility rates: a quasi-experimental study

et al. 2020

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Background: From 2000 to 2008, in urban areas in Spain, adolescent fertility and abortion rates underwent unprecedented increases, consecutive to intensive immigration from developing countries. To address unmet needs for contraception information and services, a community-based, gender-sensitive and culturally adapted brief counselling intervention (SIRIAN program) was launched in some deprived neighbourhoods with a high proportion of immigrants in Barcelona. Once a randomized controlled trial demonstrated its effectiveness in increasing the use of contraceptives, we aim to examine its population impact on adolescent fertility rates. Methods: Quasi-experimental study with comparison group, using population data from 2005 to 2016. Five neighbourhoods in the lowest tercile of Disposable Household Income were intervened in 2011-13. The comparison group included the three neighbourhoods which were in the same municipal district and in the lowest Disposable Household Income tercile, and displayed the highest adolescent fertility rates. Generalized linear models were fitted to assess absolute adolescent fertility rates and adjusted by immigrant population between pre-intervention (2005-10) and post-intervention periods (2011-16); Difference in Differences and relative pre-post changes analysis were performed. Results: In 2005-10 the intervention group adolescent fertility rate was 27.90 (per 1000 women 15-19) and 21.84 in the comparison group. In 2011-16 intervention areas experienced great declines (adolescent fertility rate change: − 12.30 (− 12.45 to − 12.21); p < 0.001), while comparison neighbourhoods remained unchanged (adolescent fertility rate change: 1.91 (− 2.25 to 6.07); p = 0.368). A reduction of − 10.97 points (− 13.91 to − 8.03); p < 0.001) is associated to the intervention. Conclusion: Adolescent fertility rate significantly declined in the intervention group but remained stable in the comparison group. This quasi-experimental study provide evidence that, in a country with universal health coverage, a community counselling intervention that increases access to contraception, knowledge and sexual health care in hard-to-reach segments of the population can contribute to substantially reduce adolescent fertility rates. Reducing adolescent fertility rates could become a feasible goal in cities with similar conditions.

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Interventions for improving health literacy in migrants

Baumeister,

Aldin,

Chakraverty

et al. 2023

Cochrane Database of Systematic Reviews

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Effects of a counselling intervention to improve contraception in deprived neighbourhoods: a randomized controlled trial

Abstract: This brief counselling intervention increased the consistent use of effective contraception in low-income neighbourhoods with a high proportion of immigration.

Cited by 11 publications

References 26 publications

Contraceptive use among migrant, second-generation migrant and non-migrant women seeking abortion care: a descriptive cross-sectional study conducted in Sweden

Contraceptive use among migrant, second-generation migrant and non-migrant women seeking abortion care: a descriptive cross-sectional study conducted in Sweden

Impact of a community contraceptive counselling intervention on adolescent fertility rates: a quasi-experimental study

Interventions for improving health literacy in migrants

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