title: Effectiveness of evidence-based medicine on knowledge, attitudes, and practices of family planning providers: a randomized experiment in Jordan.
abstract: BACKGROUND
  Provider misconceptions and biases about contraceptive methods are major barriers to family planning access for women in low- and middle-income countries, including Jordan. Evidence-Based Medicine (EBM) programs aim to reduce biases and misconceptions by providing doctors with the most up-to-date scientific evidence on contraceptive methods.
  
  
  METHODS
  We evaluate the effects of an EBM program conducted in Jordan on private providers' knowledge, attitudes, and practices. Family planning providers randomly assigned to a treatment group were invited to attend a roundtable seminar on the injectable contraceptive Depot Medroxy Progesterone Acetate (DMPA), and to receive two 15 min one-on-one educational visits that reinforce the messages from the seminar.
  
  
  RESULTS
  There was low compliance with the EBM program. The study fails to detect an impact on providers' knowledge of DMPA's side effects or on reported clinical practices. There is suggestive evidence of a positive impact on providers' attitudes toward and confidence in prescribing the contraceptive to their patients. There is also evidence of positive selection into program participation.
  
  
  CONCLUSIONS
  We conclude that EBM may not be effective as a stand-alone program targeting a family planning method with a high level of provider and consumer bias. Evidence of positive selection into program participation underscores the importance of randomization to avoid overestimating the true effects of interventions.
  
  
  BACKGROUND
  AEA RCT Registry, AEARCTR0000539 , 11/3/2014.
authors.affiliation: International Health Division, Abt Associates Inc, Bethesda, MD, USA. Marianne_ElKhoury@abtassoc.com.
authors.forename: Marianne
authors.initials: M
authors.lastname: El-Khoury
authors.affiliation: Department of Economics, University of Illinois at Urbana-Champaign, Urbana, IL, USA. rebeccat@illinois.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Thornton
authors.affiliation: Internaltional Health Division, Abt Associates Inc, Bethesda, MD, USA. Minki_Chatterji@abtassoc.com.
authors.forename: Minki
authors.initials: M
authors.lastname: Chatterji
authors.affiliation: The Williams Institute, University of California Los Angeles, School of Law, Los Angeles, CA, USA. choi@law.ucla.edu.
authors.forename: Soon Kyu
authors.initials: SK
authors.lastname: Choi
mesh_terms: D003267:Contraception; D019317:Evidence-Based Medicine; D005193:Family Planning Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007597:Jordan; D008297:Male; D011795:Surveys and Questionnaires