ResearchGeneral gynecologyTailored intervention to increase dual-contraceptive method use: a randomized trial to reduce unintended pregnancies and sexually transmitted infections
Section snippets
Materials and Methods
A complete and detailed report of the methods of Project PROTECT is described elsewhere6; a summary of these methods is provided in the following text. Institutional review board approval was obtained before the initiation of recruitment. Between October 1999 and October 2003, we screened and recruited 542 participants. To be eligible for the trial, women had to be English speaking, between the ages of 13 and 35 years, sexually active with a male partner in the past 6 months, and at high risk
Results
Of the 1112 women screened for Project PROTECT, 916 were eligible (Figure 1). We collected data on age, race, unintended pregnancy and STI history, and contraceptive use on all patients screened. The characteristics of the patients randomized (n = 542) were similar to the patients screened eligible but not enrolled (Table 1). However, patients enrolled were more likely to be non-Hispanic black (26% vs 19%) and somewhat less likely to use hormonal contraceptive methods (33% vs 38%).
The
Comment
The intervention based on the transtheoretical model of behavior change resulted in an increase in our primary behavioral outcome, self-reported dual-method contraceptive use, compared with the control. However, there were no differences in the number of incident STIs or unintended pregnancies. It is possible that the intervention was more effective at the reported initiation of dual-method use, but the duration of use and adherence were not sustained long enough to translate into a reduction
Acknowledgments
The authors acknowledge Joseph Hogan, ScD (Center for Statistical Sciences, Brown University, Providence, RI) for his early contributions to the study design and statistical analysis.
References (16)
- et al.
Design of a stage-matched intervention trial to increase dual method contraceptive use (Project PROTECT)
Contemp Clin Trials
(2007) - et al.
Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer and receive regular mammograms
Prev Med
(2005) - et al.
The potential role of contraception in reducing abortion
Studies in Family Planning
(2000) Unintended pregnancy in the United States
Fam Plann Perspect
(1998)- et al.
Disparities in rates of unintended pregnancy in the United States, 1994 and 2001
Perspect Sex Reprod Health
(2006) Sexually transmitted disease surveillance, 2006
(2007)- et al.
Interrelationships among human immunodeficiency virus type 1 infection, bacterial vaginosis, trichomoniasis, and the presence of yeasts
J Infect Dis
(2002) Clinical practiceGenital chlamydial infections
N Engl J Med
(2003)
Cited by (50)
Electronic interventions for changing knowledge, attitudes or practices regarding contraception: a systematic review
2019, ContraceptionCitation Excerpt :At 3-month follow-up, a smaller proportion of participants in the intervention group had unintended pregnancies (0.9%) compared to the control group (3.8%), though this difference was not statistically significant. A TTM-based intervention focused on increasing dual-method uptake and adherence among women in the US found no significant difference in rates of unintended pregnancy between intervention and control groups at 24-month follow-up (HR=1.22, 95% CI 0.73–2.04) [29]. However, the authors noted limited power to detect effects of interest due to increased use of condoms in the control arm.
Condom use and incident sexually transmitted infection after initiation of long-acting reversible contraception
2017, American Journal of Obstetrics and GynecologyA Randomized Controlled Trial to Compare Computer-assisted Motivational Intervention with Didactic Educational Counseling to Reduce Unprotected Sex in Female Adolescents
2016, Journal of Pediatric and Adolescent GynecologyCitation Excerpt :More recently, an uncontrolled pilot study that assessed a single-session, computer-delivered TTM intervention to increase condom use found that this technology was acceptable and feasible in a group of high-risk female adolescents.16 A randomized controlled trial that delivered a TTM-tailored intervention with computer-based tailored feedback that targeted dual-method contraception use among 542 women (median age of participants was 22 years old), did not find an effect for incident STD outcomes.17 Although the TTM provides a framework for assessment of readiness to change, motivational interviewing (MI) provides an empirically-supported style for matching counseling to an individual’s readiness to change.18
Male involvement in family planning program in Northern Ethiopia: An application of the Transtheoretical model
2015, Patient Education and Counseling
This study was supported by Grants R01-HD36663 and K24 HD01298 from the National Institute of Child Health and Human Development.
Cite this article as: Peipert JF, Redding CA, Blume JD, et al. Tailored intervention to increase dual-contraceptive method use: a randomized trial to reduce unintended pregnancies and sexually transmitted infections. Am J Obstet Gynecol 2008;198:630.e1-630.e8.
Reprints not available from the authors.