title: Impact of Contraceptive Counseling in Clinical Settings: A Systematic Review.
abstract: BACKGROUND
  This systematic review evaluated the evidence on the impact of contraceptive counseling provided in clinical settings on reproductive health outcomes to provide information to guide national recommendations on quality family planning services.
  
  
  METHODS
  Multiple databases were searched during 2010-2011 for peer-reviewed articles published in English from January 1985 through February 2011 describing studies that evaluated contraceptive counseling interventions in clinical settings. Studies were excluded if they focused primarily on prevention of HIV or sexually transmitted infections, focused solely on men, or were conducted outside the U.S., Canada, Europe, Australia, or New Zealand.
  
  
  RESULTS
  The initial search identified 12,327 articles, of which 22 studies (from 23 articles) met the inclusion criteria. Six studies examined the impact of contraceptive counseling among adolescents, with four finding a significant positive impact on at least one outcome of interest. Sixteen studies examined the impact of counseling among adults or mixed populations (adults and adolescents), with 11 finding a significant positive impact on at least one outcome of interest.
  
  
  CONCLUSIONS
  Promising components of contraceptive counseling were identified despite the diversity of interventions and inability to compare the relative effectiveness of one approach versus another. The evidence base would be strengthened by improved documentation of counseling procedures; assessment of intervention implementation and fidelity to put study findings into context; and development and inclusion of more RCTs, studies conducted among general samples of women, and studies with sample sizes sufficient to detect important behavioral outcomes at least 12 months post-intervention.
authors.affiliation: Division of Reproductive Health, CDC, Atlanta, Georgia. Electronic address: lzapata@cdc.gov.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Zapata
authors.affiliation: Manila Consulting Group, Inc., McLean, Virginia.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Tregear
authors.affiliation: Division of Reproductive Health, CDC, Atlanta, Georgia.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Curtis
authors.affiliation: Manila Consulting Group, Inc., McLean, Virginia.
authors.forename: Marie
authors.initials: M
authors.lastname: Tiller
authors.affiliation: Division of Reproductive Health, CDC, Atlanta, Georgia.
authors.forename: Karen
authors.initials: K
authors.lastname: Pazol
authors.affiliation: Office of Population Affairs, USDHHS, Rockville, Maryland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Mautone-Smith
authors.affiliation: Office of Population Affairs, USDHHS, Rockville, Maryland.
authors.forename: Loretta E
authors.initials: LE
authors.lastname: Gavin
mesh_terms: D001315:Australia; D002170:Canada; D003267:Contraception; D003376:Counseling / Q000379:methods*; D005060:Europe; D005193:Family Planning Services / Q000592:standards*; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D009520:New Zealand; D016032:Randomized Controlled Trials as Topic; D014481:United States