Tailored intervention to increase dual-contraceptive method use: a randomized trial to reduce unintended pregnancies and sexually transmitted infections.
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.
Peipert
Jeffrey F
JF
Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St Louis School of Medicine, St Louis, MO, USA.
Redding
Colleen A
CA
Blume
Jeffrey D
JD
Allsworth
Jenifer E
JE
Matteson
Kristen A
KA
Lozowski
Faye
F
Mayer
Kenneth H
KH
Morokoff
Patricia J
PJ
Rossi
Joseph S
JS
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
D003278:Contraceptives, Oral, Hormonal