Impact of Contraceptive Counseling in Clinical Settings

Self Cite

Context Educational interventions can help increase knowledge of available contraceptive methods, enabling individuals to make informed decisions and use contraception more effectively. This systematic review evaluated contraceptive education interventions to guide national recommendations on quality family planning services. Evidence acquisition Three databases (CINAHL, PubMed, and PsycINFO) were searched from 1985 through 2012 for peer-reviewed articles on educational interventions, with supplemental searches conducted through 2015. Primary outcomes were knowledge, participation in and comfort with decision making, and attitudes toward contraception. Secondary outcomes included contraceptive use behaviors and unintended pregnancy. Evidence synthesis Database searches in 2011 identified 5,830 articles; 17 met inclusion criteria and were abstracted into evidence tables. Searches in 2012 and 2015 identified four additional studies. Studies used a wide range of tools (decision aids, written materials, audio/videotapes, and interactive games), with and without input from a healthcare provider or educator. Of 15 studies that examined the impact of educational interventions on knowledge, 14 found significant improvement using a range of tools, with and without input from a healthcare provider or educator. Fewer studies evaluated outcomes related to decision making, attitudes toward contraception, contraceptive use behaviors, or unintended pregnancy. Conclusions Results from this systematic review are consistent with evidence from the broader healthcare field suggesting that a range of educational interventions can increase knowledge. Future studies should assess what aspects of educational interventions are most effective, the extent to which it is necessary to include a healthcare provider or educator, and the extent to which educational interventions can impact behaviors.

Section: Evidence Acquisitionsupporting

confidence: 56%

“…The absence of studies finding an impact on our secondary outcomes likely is related to the fact that educational interventions are generally intended to impact short-term outcomes such as knowledge, whereas broader counseling interventions are theorized to address outcomes that are associated with behavioral changes. 17 …”

Section: Discussionmentioning

confidence: 99%

Impact of Contraceptive Education on Contraceptive Knowledge and Decision Making

Pazol¹,

Zapata²,

Tregear

et al. 2015

Self Cite

“…There is such limited evidence available on the impact of reminder systems that it is difficult to draw conclusions about when and for whom they might be effective. Along with expert feedback and findings from two other complementary systematic reviews on the impact of contraceptive counseling 27 and education 28 in family planning programs, the information was used to develop recommendations for providing quality contraceptive counseling in the 2014 “Providing Quality Family Planning Services.” 29 The evidence base on the impact of reminder systems in clinical settings to improve family planning outcomes would be strengthened by the development of additional studies, especially RCTs, which objectively measure outcomes, examine additional contraceptive methods, and have sample sizes that are large enough to detect behavioral outcomes at least 12 months post-intervention.…”

Section: Discussionmentioning

confidence: 99%

Impact of Reminder Systems in Clinical Settings to Improve Family Planning Outcomes

Zapata¹,

Tregear

Tiller

et al. 2015

Self Cite

Context This systematic review evaluated the evidence on the impact of family planning reminder systems—interventions intended to remind patients of behaviors to achieve reproductive health goals (e.g., daily text messages reminding oral contraceptive [OC] users to take a pill)—to provide information to guide national recommendations on quality family planning services. Evidence acquisition Multiple databases including PubMed were searched during 2010–2011 for peer-reviewed articles published in English from January 1985 through February 2011 describing studies evaluating reminder systems to improve family planning outcomes. Studies were excluded if they focused primarily on HIV or sexually transmitted infection prevention, focused solely on men, or were conducted outside the U.S., Europe, Australia, or New Zealand. Evidence synthesis The initial search identified 16,129 articles, five of which met the inclusion criteria. Three studies examined the impact of OC reminder systems; two found a statistically significant positive impact on correct use. Two studies examined the impact of reminder systems among depot medroxyprogesterone acetate (DMPA) users; one found a statistically significant positive impact on correct use. Conclusions Although mixed support was found for the effectiveness of reminder system interventions on correct use of OCs and DMPA, the highest-quality evidence yielded null findings. The evidence base would be strengthened by the development of additional studies, especially RCTs, which objectively measure outcomes, examine additional contraceptive methods, and have sufficient sample sizes to detect behavioral outcomes at least 12 months post-intervention.

“…Increased emphasis on contraceptive counseling and services may also be fueled by new evidence-based SRH clinical practice guidelines advanced by governmental agencies and medical organizations including the Centers for Disease Control and Prevention, the Office of Population Affairs, American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, and the Society for Adolescent Health and Medicine. 16 – 21 …”

Section: Introductionmentioning

confidence: 99%

Trends in Receipt of Contraceptive Services: Young Women in the U.S., 2002–2015

Frost

Lindberg

2019

Introduction: In order to understand adolescent girls’ and young women’s use of contraceptive services, this paper examines trends in receipt of contraceptive services, focusing on provider type and payment source. Methods: The analysis uses nationally representative data from females aged 15–25 years in the 2002, 2006–2010, and 2011–2015 National Surveys of Family Growth. In 2018, summary measures for receipt of any contraceptive service, the type of provider visited and payment used were created and compared across survey years and age groups (15–17 and 18–25 years). Results: From 2002 to 2011–2015, the proportion of adolescent girls aged 15–17 years relying on publicly funded clinics for contraceptive care fell from 47% to 24% (95% CI=38.4%, 55.0% and 95% CI=19.0%, 29.9%), whereas the proportion relying on private providers increased from 49% to 69% (95% CI=40.7%, 57.1% and 95% CI=61.6%, 76.2%). A significant, but smaller, shift away from clinics occurred among women aged 18–25 years. Over the same period, use of health insurance to pay for contraceptive services among all females aged 15–25 years increased from 68% to 81% (95% CI=64.7%, 71.3% and 95% CI=78.5%, 83.8%), whereas the proportion who had private insurance during the year, but did not use it to pay for contraceptive care, declined from 21% to 9% (95% CI=18.3%, 23.5% and 95% CI=6.8%, 10.7%). Conclusions: Private providers now provide the bulk of contraceptive services to adolescent girls and young women, with reduced reliance on publicly funded clinics. Supporting private practices in providing confidential and comprehensive family planning services must be a priority. Publicly funded clinics remain an important safety-net provider of contraceptive care for adolescent girls and young women.