title: Tailored intervention to increase dual-contraceptive method use: a randomized trial to reduce unintended pregnancies and sexually transmitted infections.
abstract: OBJECTIVE
  The objective of the study was to determine whether a transtheoretical model-tailored expert system intervention increases dual-method contraceptive use, compared with a nontailored educational intervention.
  
  
  METHODS
  We performed a randomized clinical trial of 542 women at high risk for sexually transmitted infections (STIs) and unintended pregnancy. The intervention group received computer-based tailored feedback using a multimedia program. The control group received general contraceptive information and nontailored advice.
  
  
  RESULTS
  Participants in the intervention group were more likely to report use of dual contraceptive methods during follow-up (adjusted hazard rate ratio 1.70, 95% confidence interval 1.09, 2.66), compared with controls. However, there were no differences in the rates of incident STI or unintended pregnancy between the 2 groups.
  
  
  CONCLUSIONS
  The computer-based transtheoretical model-tailored intervention resulted in a 70% increase in reported dual-method contraceptive use in a group of women at high risk for STIs and unintended pregnancy. Inconsistent use of dual methods may explain the lack of effect on unintended pregnancy rates and incident STIs.
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St Louis School of Medicine, St Louis, MO, USA.
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.forename: Colleen A
authors.initials: CA
authors.lastname: Redding
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Blume
authors.forename: Jenifer E
authors.initials: JE
authors.lastname: Allsworth
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Matteson
authors.forename: Faye
authors.initials: F
authors.lastname: Lozowski
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Morokoff
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Rossi
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods*; D042121:Contraception, Barrier; D003278:Contraceptives, Oral, Hormonal; D005246:Feedback; D005260:Female; D006801:Humans; D008962:Models, Theoretical; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D013242:Sterilization
chemical_list: D003278:Contraceptives, Oral, Hormonal