Empowering Women to Make Contraceptive Choices While Incarcerated
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Contraception
- Sponsor
- Memorial Hospital of Rhode Island
- Enrollment
- 400
- Locations
- 1
- Primary Endpoint
- Contraceptive initiation
- Last Updated
- 15 years ago
Overview
Brief Summary
The purpose of this study is to increase the initiation and continuation of highly effective contraceptive use while incarcerated and upon release, as well as decrease unsafe sexual activity.
Detailed Description
Unplanned pregnancies and sexually transmitted infections are important and costly public health problems in the United States resulting from unprotected sexual activity. Women with a history of incarceration are at increased risk for these problems given the high rates of substance abuse and commercial sex work in this population. This proposal is designed to evaluate an innovative intervention Motivational Interviewing with Computer Assistance (MICA) designed to improve contraceptive use for incarcerated women who do not want a pregnancy and are soon to be released into the community. The investigators will utilize the Title X program which, in conjunction with RI Department of Corrections (RI DOC), provides reproductive health services in jail and then transitional services in the community after release. The investigators plan to recruit 400 women from the RI DOC women's jail and randomize them to two interventions: two sessions of personalized MICA or two sessions of Didactic Educational Counseling (DEC), both delivered individually by trained counselors. The two counseling interventions will be similar in length and timing, but will vary in content, counseling style and the individualized computer generated feedback that is reviewed with the counselor.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Currently sexually active with men defined as having coital sex at least monthly in the past three non-institutionalized months;
- •Expected place of residence after release in Providence County or within 15 miles of follow-up site;
- •Willing to comply with protocol, follow-up and provide at least one locator;
- •Fluent in English.
Exclusion Criteria
- •Inability to give informed consent secondary to organic brain dysfunction, not having own legal guardianship, or active psychosis or otherwise not able to participate in the intervention or assessments (deaf, blind, or impaired communication skills that impair ability to participate in computerize assessment or counseling);
- •Pregnant or trying to become pregnant within the next year;
- •Hysterectomy, bilateral oophorectomy, tubal ligation, IUD or Essure (coil), implantable contraceptive devices (Implanon) or other procedures which make it very unlikely to become pregnant;
- •Women who are monogamous for more than one year whose partner has had a vasectomy;
- •Housed in segregation as we will be unable to recruit them for the study
Outcomes
Primary Outcomes
Contraceptive initiation
Time Frame: 5 years
Initiation of a highly effective contraceptive method prior to release from jail will be limited to methods that are 98% or more effective in preventing pregnancy (Table 1).41 Initiation of these methods will be verified through review of the RI DOC medical records (as we have done in the past).
Continuous use of highly effective contraceptives at follow-up
Time Frame: 5 years
If a participant switches from one highly effective contraceptive method to another she will be recorded as maintaining continuous contraceptive use at follow-up if she switches methods during times when the original method is still effective. Use of contraceptive methods will be confirmed through both TLFB and medical record review.
Incident STIs
Time Frame: 5 years
At baseline participants will be tested for T. vaginalis, N. gonorrhoeae, and C. trachomatis through self obtained vaginal swabs. If a participant is diagnosed with an STI at baseline she will be treated and she will be asked to follow-up in six weeks for a test for cure. Any positive test after a baseline negative test will be documented as an incident infection.
Secondary Outcomes
- Incident pregnancy(5 years)
- Risk for unintended pregnancy and STIs(5 years)