Innovative Model of Patient-Centered ConTraception

Not Applicable

Completed

Brief Summary: This study is testing models of contraceptive care that were developed as part of the Contraceptive CHOICE Project. CHOICE is a prospective cohort study of 9,256 women designed to: 1) promote the use of long-acting reversible contraceptive (LARC) methods which include interuterine devices (IUD) and subdermal implants; 2) remove financial barriers to contraception; 3) evaluate continuation of and satisfaction with reversible methods; and 4) reduce unintended pregnancies in the St. Louis region. CHOICE demonstrated that interventions such as comprehensive contraceptive counseling, increased access, and removal of financial barriers increase the uptake of LARC methods and reduce unintended pregnancy. The investigators objective is to determine whether the CHOICE model of contraceptive care can be equally successful in the real world of community clinics.

Detailed Description: This project involves comparing two models of contraceptive care; 'enhanced care' which is usual care plus the CHOICE structured contraceptive counseling, and the 'complete CHOICE' group which includes the structured contraceptive counseling as well as provider training and cost support for IUDs and implants. Participants will be enrolled at three partner community clinics by a staff member (site coordinator) dedicated to the research study. All participants will undergo contraceptive counseling as well as a baseline survey with the coordinator. Participants will complete telephone surveys at 3, 6, and 12 months post-enrollment and will be asked about contraceptive method chosen, satisfaction and continuation of the method, and any pregnancies experienced since enrollment.

Recruitment & Eligibility

Inclusion Criteria

14-45 years of age
Does not desire pregnancy during the next 12 months
Desires reversible contraception
Sexually active with a man within the past 6 months or intend to have sex with a man in the next 3 months
Willing and able to undergo informed consent
Willing to comply with study protocol and 1-year follow-up schedule
Not currently pregnant
Current patient at Family Care Carondelet, Family Care Forest Park Southeast, Memphis Health Center

Exclusion Criteria

Has undergone a female sterilization procedure such as tubal ligation or hysterectomy
Has one sexual partner who has undergone a vasectomy procedure
Speaks language other than English or Spanish
Currently using an IUD or implant as her contraceptive method

Primary Outcome Measures

Name	Time	Method
Unintended Pregnancy	12 months	The number of self-reported unintended pregnancies.

Secondary Outcome Measures

Name	Time	Method
Desired Contraceptive Method at Enrollment Visit	On the day of enrollment	This could be a new method, an existing method, or nothing if participant did not choose a method
Same Day LARC Insertion	On the day of enrollment	Of the participants who chose LARC as their preferred method, the number who received the device the same day as their enrollment visit.
Contraceptive Method Use Upon Enrollment Completion	On the day of enrollment	This measure indicates the contraceptive method that the patient left with after the clinical visit on the day of enrollment. Patients could have received desired new method, received a bridge method, stayed on current method, or received no method.
Participants Choosing Long-Acting Reversible Contraception (LARC) at Enrollment Visit	On the day of enrollment	Number of women choosing an IUD or implant as their preferred contraceptive method

Locations (3): Family Care Health Center Forest Park
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Saint Louis, Missouri, United States
Family Care Health Center Carondelet
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Saint Louis, Missouri, United States
Memphis Health Center
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Memphis, Tennessee, United States
Family Care Health Center Forest Park
🇺🇸Saint Louis, Missouri, United States