title: Reproductive Life Plan Counseling and Effective Contraceptive Use among Urban Women Utilizing Title X Services.
abstract: BACKGROUND
  Although the Centers for Disease Control and Prevention and the U.S. Office of Population Affairs recommend inclusion of reproductive life plan counseling (RLPC) in all well-woman health care visits, no studies have examined the effect of RLPC sessions on the decision to use effective contraception at publicly funded family planning sites. RLPC could be a particularly impactful intervention for disadvantaged social groups who are less likely to use the most effective contraceptive methods.
  
  
  METHODS
  Using data from 771 nonpregnant, non-pregnancy-seeking women receiving gynecological services in the Cincinnati-Hamilton County Reproductive Health and Wellness Program, multinomial logistic regression models compared users of nonmedical/no method with users of 1) the pill, patch, or ring, 2) depot medroxyprogesterone acetate, and 3) long-acting reversible contraception (LARC). The effect of RLPC on the use of each form of contraception, and whether it mediated the effect of race/ethnicity and education on contraceptive use, was examined while controlling for age, insurance status, and birth history. The interaction between RLPC and race/ethnicity and the interaction between RLPC and educational attainment was also assessed.
  
  
  RESULTS
  RLPC was not associated with contraceptive use. The data suggested that RLPC may increase LARC use over nonmedical/no method use. RLPC did not mediate or moderate the effect of race/ethnicity or educational attainment on contraceptive use in any comparison.
  
  
  CONCLUSIONS
  In this system of publicly funded family planning clinics, RLPC seems not to encourage effective method use, providing no support for the efficacy of the RLPC intervention. The results suggest that this intervention requires further development and evaluation.
authors.affiliation: Department of Sociology, University of Cincinnati, Cincinnati, Ohio; Cincinnati-Hamilton County Reproductive Health and Wellness Program, Cincinnati, Ohio. Electronic address: bommarap@mail.uc.edu.
authors.forename: Aalap
authors.initials: A
authors.lastname: Bommaraju
authors.affiliation: Department of Sociology, University of Cincinnati, Cincinnati, Ohio; Kunz Center for Social Research, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Malat
authors.affiliation: Department of Sociology, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Mooney
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000191:economics / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D037001:Directive Counseling; D005193:Family Planning Services / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005380:Financing, Government; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007196:Indiana; D060728:Reproductive Health; D012959:Socioeconomic Factors; D014481:United States; D014505:Urban Population