Introducing reproductive life plan-based information in contraceptive counselling: an RCT

Abstract

STUDY QUESTIONCan reproductive life plan (RLP)-based information in contraceptive counselling before pregnancy increase women's knowledge of reproduction, and of the importance of folic acid intake in particular?SUMMARY ANSWERThe RLP-based information increased women's knowledge of reproduction including knowledge of folic acid intake.WHAT IS KNOWN ALREADYMany women have insufficient knowledge of reproduction, including a health-promoting lifestyle prior to conception, and highly educated women in particular postpone childbearing until an age when their fertile capacity has started to decrease.STUDY DESIGN, SIZE, DURATIONThe study was an randomized controlled trial with one intervention group (IG) and two control groups (CG1, CG2). A sample size calculation indicated that 82 women per group would be adequate. Recruitment took place during 3 months in 2012 and 299 women were included. The women were randomized in blocks of three. All groups received standard care (contraceptive counselling, Chlamydia testing, cervical screening). In addition, women in the IG were given oral and written RLP-based information about reproduction.PARTICIPANTS/MATERIALS, SETTING, METHODSA total of 299 out of 338 (88%) Swedish-speaking women visiting a Student Health Centre were included (mean age 23 years); response rate was 88%. Before the counselling, women in the IG and the CG1 completed a baseline questionnaire, including questions about lifestyle changes in connection to pregnancy planning, family planning intentions and knowledge of reproduction (e.g. the fecundity of an ovum). At follow-up 2 months after inclusion, a structured telephone interview was performed in all groups (n = 262, 88% participation rate).MAIN RESULTS AND THE ROLE OF CHANCEThere was no difference between the groups regarding the mean knowledge score at baseline. The IG scored higher at follow-up than at baseline (P < 0.001); the mean increased from 6.4 to 9.0 out of a maximum 20 points. The women in the CG1 scored no differently at follow-up than at baseline. The difference in the knowledge score between the IG and the two CGs was significant (P < 0.001), whereas no difference was shown between the two CGs. There was no difference between the groups at baseline regarding how many women could mention folic acid intake among the things to do when planning to get pregnant. At follow-up, 22% in the IG, 3% in CG1 and 1% in CG2 mentioned folic acid intake (P < 0.001). At follow-up, more women in the IG also wished to have their last child earlier in life (P < 0.001) than at baseline, while there was no difference in the CG1.LIMITATIONS, REASONS FOR CAUTIONAs the study sample consisted of university students, it is possible that the effect of the intervention was connected to a high level of education and conclusions for all women of reproductive age should be drawn with caution.WIDER IMPLICATIONS OF THE FINDINGSThe provision of RLP-based information seems to be a feasible tool for promoting reproductive health.STUDY FUNDING/COMPETING INTEREST(S)Study funding was re...

Effectiveness of a video intervention on fertility knowledge among university students: a randomised pre-test/post-test study

“…The effectiveness of our intervention regarding knowledge on age-related fertility decline was also verified in previous intervention studies consisting in written information 7,8 , or a combination of oral and written information 9 . Findings regarding knowledge on treatment success rates are also in accordance with previous evidence 7,9 , as well as on the definition on infertility 7 . There is no previous evidence supporting our findings regarding female fertile age range and chance of pregnancy over the course of 1 year per age intervals.…”

“…The scarce evidence available points to maintenance of knowledge two months later 9 , and a partial loss of knowledge after six months 8 (even though there was no control group in this later study). More evidence is needed to address this gap concerning long-term effectiveness.…”

Evaluation of service quality in family planning clinics in Lusaka, Zambia

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