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. Study Design We performed a randomized clinical trial of 542 women at high risk fo...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2008-06, Vol.198 (6), p.630.e1-630.e8
Main Authors: Peipert, Jeffrey F., MD, PhD, Redding, Colleen A., PhD, Blume, Jeffrey D., PhD, Allsworth, Jenifer E., PhD, Matteson, Kristen A., MD, Lozowski, Faye, BA, Mayer, Kenneth H., MD, Morokoff, Patricia J., PhD, Rossi, Joseph S., PhD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
contraception
Contraception - methods
Contraception, Barrier
Contraceptives, Oral, Hormonal
Epidemiology. Vaccinations
Feedback
Female
General aspects
Gynecology. Andrology. Obstetrics
Humans
Infectious diseases
Medical sciences
Models, Theoretical
Obstetrics and Gynecology
Pregnancy
Pregnancy, Unplanned
prevention
sexually transmitted diseases
Sexually Transmitted Diseases - prevention & control
Sterilization
unplanned pregnancy
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Summary: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. Study Design 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.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2008.01.038