Structured contraceptive counseling--a randomized controlled trial.
OBJECTIVE
To evaluate the addition of structured contraceptive counseling to usual care on choice, initiation, and continuation of very effective contraception after uterine aspiration.


METHODS
We conducted a RCT of a version of the WHO Decision-Making Tool for Family Planning Clients and Providers with women having a procedure for a spontaneous or induced abortion. Our intervention provided structured, standardized counseling. We randomized women to usual care or usual care with structured counseling. Our outcomes included choosing a very effective contraceptive method and 3 months continuation.


RESULTS
Fifty-four percent of all participants chose a very effective method. Women in the intervention group were no more likely to choose a very effective method (OR 0.74, 95% CI 0.44, 1.26) or to initiate their method compared to the usual care group (OR 0.65, 95% CI 0.31, 1.34). In multivariate models, structured counseling was not associated with using a very effective method at 3 months (AOR 1.06, 95% CI 0.53, 2.14).


CONCLUSIONS
In this setting, structured counseling had little impact on contraceptive method choice, initiation, or continuation.


CONCLUSIONS
Adding structured counseling did not increase the proportion choosing or initiating very effective contraception in a practice setting where physicians already provide individualized counseling.
Langston
Aileen M
AM
Division of Family Planning and Preventive Services, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA. al2632@columbia.edu
Rosario
Linette
L
Westhoff
Carolyn L
CL
D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D003267:Contraception; D003268:Contraception Behavior / Q000523:psychology; D003271:Contraceptive Agents, Female; D003376:Counseling; D003661:Decision Support Techniques; D005193:Family Planning Services / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009518:New York; D010353:Patient Education as Topic / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D049168:Pregnancy, Unplanned; D016896:Treatment Outcome; D055815:Young Adult
D003271:Contraceptive Agents, Female