Author | Date | Reference | Study/document objectives | Resource type | Setting | Summary of content | Findings | |
1 | World Health Organization (WHO) | 2005 | WHO. Decision-making tool for family planning clients and providers. 2005 https://www.who.int/reproductivehealth/publications/family_planning/9241593229index/en/ | A technical adaptation guide for the generic WHO DMT to enable it to be used in all countries. | Tool - used by client and provider during consultation. | Global | A double-sided DMT - developed for global adaptation. One page faces the client (with simple information on key issues for the client to consider) and a corresponding page faces the provider (with key points and detailed reference information). Healthcare providers can use it step-by-step to help clients make informed choices that suit their needs. The Kim et al (2005) and Johnston et al (2010) papers are evaluations of this tool. | N/A |
2 | Kim et al 19 | 2005 | Kim YM, Kols A, Martin A, et al. Promoting informed choice: evaluating a decision-making tool for family planning clients and providers in Mexico. Int Fam Plan Perspect 2005;31:162–71. https://www.guttmacher.org/sites/default/files/pdfs/pubs/journals/3116205.pdf | To evaluate use of the WHO contraceptive DMT in a Mexican setting | (Evaluation of) Tool - used by client and provider during consultation. | Mexico | Reports the testing of the WHO DMT in a Mexican setting. Method of evaluation involved videotaping consultations pre- and post-use of tool and carrying out exit interviews with clients. Measured outcomes were 'active client participation' and 'facilitative provider communication'. The decision-making processes during the consultation were also evaluated. | Clients using tool spoke more and participated more actively in consultations. Facilitative provider communication increased. Length of counselling sessions increased. Clients participated more actively in decision making and providers facilitated this better post-intervention. A shift from provider-dominated to shared decision-making occurred with use of tool and the amount of information given by providers to clients increased. |
3 | Johnson et al | 2010 | Johnson SL, Kim YM, Church K. Towards client-centred counselling: development and testing of the WHO decision-making tool. Patient Educ Couns 2010;81:355–61. doi:10.1016/j.pec.2010.10.011 | To explain how the WHO DMT works and how it can be used to support contraceptive consultations. Reports findings from evaluation in three countries: Mexico, Indonesia and Nicaragua. | (Evaluation of) Tool - used by client and provider during consultation. | Global | This paper explains the effects of the WHO DMT where the provider may not have adequate knowledge. The tool is designed to ensure that the client receives full information on what to expect when using the method, including side effects. Guidance is also provided for discussions with returning clients. The tool enables the provider to offer support for the continuing client, including for switching methods when the client desires. | Advantages are: tool facilitates evidence-based best practice in counselling; the client is more likely to receive the method that she or he has in mind; the provider offers information that is tailored, well-structured, and concise; the tool facilitates client-centred counselling processes. Summary of results from three countries found that providers tended to engage clients more; providers gave more information; the information was more tailored to the specific client. But training was necessary, and lack of time and reverting to usual practice were problems. |
4 | Dehlendorf et al 21 | 2017 | Dehlendorf C, Fitzpatrick J, Steinauer J, et al. Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counselling. Patient Educ Couns 2017;100:1374–81. doi:10.1016/j.pec.2017.02.009 | To develop and formatively evaluate a tablet-based DST for use by women prior to a contraceptive counselling visit to help them engage in shared decision-making regarding method selection. | Tool - used by client pre-consultation. | US | Describes the field testing of a DST ('My Birth Control') to facilitate shared decision-making in contraceptive counselling. This is a tablet-based decision aid to be used by women prior to their contraceptive counselling visit. Tool provides information about the aspects of contraception that are most important to the women, reflecting the preference sensitive nature of a contraceptive consultation. | In women using the tool there were trends towards greater satisfaction, and greater knowledge of LARC and IUC. |
5 | Marshall et al 22 | 2017 | Marshall C, Nuru-Jeter A, Guendelman S, et al. Patient perceptions of a decision support tool to assist with young women’s contraceptive choice. Patient Educ Couns 2017;100:343–8. doi:10.1016/j.pec.2016.08.022 | Development and evaluation of the 'Birth Control Navigator' tool for contraceptive decision-making. | Tool - used by client pre-consultation. | US | Describes the decision-making tool 'Birth Control Navigator' (https://mydoctor.kaiserpermanente.org/ncal/birthcontrol/#).The paper reports patient perceptions of the value of this DST for contraceptive decision-making. Research objectives were: (1) to identify and describe the perceived value of the DST for women’s contraceptive decision-making and (2) to determine patients’ preferences for using the tool in clinical settings. Tool is designed to be used online. | Participants found that the tool was (1) Informative, both in terms of types of contraception and details about specific contraception but cited various 'missing' information such as, for example, effect on sexual pleasure. (2) Helped to narrow down options and deal with 'information overload'. (3) Less biased and more comprehensive than a doctor. (4) Mostly seen as useful pre-consultation - in terms of narrowing options, and knowing what questions to ask. |
6 | French et al 23 | 2014 | French RS, Cowan FM, Wellings K, et al. The development of a multi-criteria decision analysis aid to help with contraceptive choices: My Contraception Tool. J Fam Plan Reprod Health Care 2014;40:96. doi:10.1136/jfprhc-2013–1 00 699 | Describes the development of the DMT, 'My Contraception Tool' and how it works. | Tool - used by client pre-consultation. | UK | The paper describes the development of 'My Contraception Tool' (MCT) to facilitate the choice of contraceptive method. MCT applies to the choice of contraceptive method the principles of multi-criteria decision analysis, a method of breaking down complex problems or questions into manageable components, and combining them to rate the various options and produce an opinion as to the best course of action. MCT is designed for use by men and women of any age who want to use contraception or to find out about different contraceptive options. This paper does not provide data on user acceptability or consultation outcomes, nor on provider experience. | N/A |
7 | Martyn et al 25 | 2006 | Martyn KK, Reifsnider E, Murray A. Improving adolescent sexual risk assessment with event history calendars: a feasibility study. J Paediatr Healthc 2006; 20:19–26. doi:10.1016/j.pedhc.2005.07.013 | Description of EHC) and report of a feasibility study piloting the tool to assess sexual risk with 30 adolescents and 2 HCPs. | Tool - used by clients pre-consultation | US | This paper describes the use by adolescents of EHCs, which are highly structured but flexible approaches to interviewing that facilitate recall of past events by using the individual’s own past experiences as cues to remembering. The adolescent risk EHC was designed to be self-administered and to collect: (a) 6- to 10-year sexual history data (starting at 10 years of age) including partners (male or female), sexual activity, contraceptive use, sexually transmitted diseases, and pregnancy and (b) contextual data including other risk behaviours (eg, substance use and violence), and risk and protective factors (eg, family, friends, role models, school and church attendance, extracurricular activities and sports). | Completing EHC took 15 min prior to consultation and 2 min to review during consultation. Adolescents found it easy to use, and helpful for remembering and discussing their health history. EHCs were perceived as time efficient and useful to identify and help with disclosure of risks. |
8 | Martyn et al 26 | 2013 | Martyn KK, Saftner MA, Darling-Fisher CS, et al. Sexual risk assessment using event history calendars with male and female adolescents. J Paediatr Healthc 2013;27:460–9. doi:10.1016/j.pedhc.2012.05.002 | To explore male and female adolescents' experiences of using the EHC tool | Tool - used by clients pre-consultation. | US | This paper describes the EHC, which is a grid with four vertical time columns labelled with four sequential years across the top of the page. Down the left side of the page are nine horizontal history categories that ask about (a) life context, including age, grade level, friends and family members involved in the adolescent’s life, activities, and positive events (eg, awards) and negative events (eg, losses and violence), (b) sexual risk behaviours, and (c) other risk behaviours (eg, drugs, alcohol, and cigarette use). | Participants spent 10–15 mins spent completing the EHC prior to the consultation and 5 min reviewing it with HCP during the consultation. Male and female adolescents used the EHC slightly differently but both reported it helped them talk about (male) or think about (female) their sexual risk. |
9 | Monasterio et al 27 | 2010 | Monasterio E, Combs N, Warner L, et al. Sexual health: an adolescent provider toolkit. San Francisco: Adolescent Health Working Group, 2010. www.ahwg.org | Comprehensive 80-page toolkit for providers of SRH to young people. | Toolkit - for providers of adolescent care. | US | This is a comprehensive, 80-page guide to many aspects of delivering SRH to adolescents. It includes sections on Practice Readiness, covering communication, consent, and adolescent development; Screening, Assessment and Referrals, covering STIs, pregnancy, sexual assault, sexual violence and sexual dysfunction; and Resources for providers giving information on types of contraception, sexual functional and pleasure and specific sections on safer sex, HPV and paternity rights. The sexual history taking template is comprehensive with suggested questions listed, and tips on communication style and relevant issues. The toolkit also provides guidance and handouts for young people, and guidance for parents. | N/A |
10 | Rogstad and Johnston29 | 2014 | Rogstad K, Johnston G. A national proforma for identifying risk of child sexual exploitation in sexual health services 'Spotting the Signs'. https://www.brook.org.uk/attachments/Spotting-the-signs-CSE-_a_national_proforma_April_2014_online.pdf | Booklet reporting the background and context for development of national 'Spotting the Signs' proforma, providing a copy of the proforma, recommendations of how to use the proforma and how to train staff, and the evidence base for the development of the proforma. | Proforma - used by providers during consultation with children and adolescents. | UK | The booklet provides an introduction to a proforma designed to help identify children at risk of child sexual abuse, a copy of the proforma itself, recommendations of how to use the proforma and how to train staff, and the evidence base for the development of the proforma. | N/A |
11 | Ashby et al 28 | 2015 | Ashby J, Rogstad K, Forsyth S, et al. Spotting the Signs: a national toolkit to help identify young people at risk of child sexual exploitation. Sex Transm Infect 2015;91:231–231. doi:10.1136/sextrans-2014–0 51 972 | A summary of progress in developing a toolkit to support use of the 'Spotting the Signs' proforma'. | Toolkit - for providers using the 'Spotting the Signs' proforma. | UK | This paper describes the development of a toolkit specifically designed to help health professionals spot child sexual exploitation. It advises on confidentiality, epidemiology and law and provides a template for areas to cover in history taking with a young person. It gives some advice on what language to use and how to ask questions, as well as what to ask. It is a development of the 'Spotting the Signs' proforma. | N/A |
12 | Holt et al 30 | 2017 | Holt K, Dehlendorf C, Langer A. Defining quality in contraceptive counselling to improve measurement of individuals’ experiences and enable service delivery improvement. Contraception 2017;96:133–7. doi:10.1016/j.contraception.2017.06.005 | To synthesise concepts from family planning, broader healthcare and health communication fields with concepts from human rights guidance related to contraceptive services to create a new quality in contraceptive counselling framework. | Framework - for consultation. | US | This paper focuses on improving patient experience in a contraceptive consultation. A framework for quality in consultations is provided in figure form. The framework has three stages: (1) Needs Assessment, (2) Decision-making Support and (3) Method Choice & Follow-up, with underpinning Foundational Relationship Building elements. The emphasis is on 'shared decision-making' rather than pure 'informed choice'. | N/A |
13 | Faculty of Sexual & Reproductive Healthcare (FRSH)31 | 2015 | FSRH. FSRH service standards consultations in sexual & reproductive health 2015. 2015;1–14. https://www.fsrh.org/standards-and-guidance/documents/servicestandardsconsultations/ | Practically focused framework document for providing high quality sexual and contraceptive health services. | Service standards framework. | UK | This document outlines quality standards for the sexual health and contraceptive consultation which include standards for confidentiality, the clinical environment (privacy and dignity), verbal and non-verbal communication skills, use of a chaperone, needs of special groups (including safeguarding) and child sexual exploitation. | N/A |
14 | Brook et al 32 | 2014 | Brook G, Bacon L, Evans C, et al. 2013 UK national guideline for consultations requiring sexual history taking. Clinical Effectiveness Group British Association for Sexual Health and HIV. Int J STD AIDS 2014;25:391–404. doi:10.1177/0956462413512807 | Clinically focused guideline for best practice in consultations requiring sexual history taking. | Clinical guideline - for providers. | UK | This guideline contains both content and process. It primarily follows the medical model of consultation. The guideline addresses confidentiality, environment, communication and content of sexual history taking - with a minimum set of questions for each gender. An additional (minimal) questions for an integrated consultation including some on contraception use and problems encountered are included. Includes advice on opening and closing the consultation and a brief section on under-16s. | N/A |
15 | Radcliffe et al 33 | 2012 | Radcliffe KW, Flew S, Poder A, et al. European guideline for the organisation of a consultation for sexually transmitted infections, 2012. Int J STD AIDS 2012;23:609–12. doi:10.1258/ijsa.2012.012115 | Intended as a framework for consultation for those working in any location where STIs are managed. | Clinical guideline - for providers. | Europe | This guideline provides a framework for the content and process of an STI consultation. It addresses confidentiality and dignity, consent and chaperones. It lists the content of sexual history-taking for men and for women, following the medical model style of fact finding. Sections also cover examination, investigations, results and treatment, partner notification and follow-up in brief list format. It does not include contraception or an approach to the process of contraceptive consultation. | N/A |
16 | Faculty of Sexual & Reproductive Healthcare (FRSH)34 | 2010 | FSRH. FSRH Clinical guidance: contraceptive choices for young people (updated May 2019). 2019;1–33. https://www.fsrh.org/standards-and-guidance/documents/cec-ceu-guidance-young-people-mar-2010/ | Clinical guidance for healthcare professionals providing contraceptive consultations for young people. | Clinical guideline - for providers. | UK | The guidelines address legal and ethical frameworks for providing contraceptive care to young people, issues of confidentiality and consent, provides guidance on how to address young people’s health concerns, risks regarding various contraceptive methods, and use of condoms to prevent STI transmission and STI testing. Brief guidance is also given on the conduct of the consultation process with regard to informing young people about confidentiality, creating a welcoming environment and avoiding barriers to communication. | N/A |
17 | Rogstad et al 35 | 2010 | Rogstad K, Thomas A, Williams O, et al. UK National guideline on the management of sexually transmitted infections and related conditions in children and young people (2009). Int J STD AIDS 2010;21:229–41. doi:10.1258/ijsa.2009.009353 | Guidance for services providing sexual health advice, management or treatment to young people in the UK. Focus is on detecting and managing child sexual exploitation, and on the medical diagnosis and management of STIs. | Clinical guideline - for providers. | UK | The guidance provides the principles that apply wherever young people are seen for sexual healthcare or where there are concerns about CSA or where a STI has been detected. Emphasis is on the detection and management of CSA with other sections minimal and often referring to other guidance for example, NICE guidelines on the 'Prevention of STIs and under 18 conceptions'. The guideline covers consent, confidentiality and child protection, and also content of sexual history, screening and testing for STIs, risk assessment for pregnancy, contraceptive advice, health education/promotion, psychological well-being and management of specific groups. It also contains a section on significance of certain infections in pre-pubertal children and appendices covering treatment protocols, risk assessment and the legal context. This guidance is comprehensive with regard to STIs in young people, and on CSA. It recognises the need for holistic practice, and includes a brief section on contraceptive advice in the context of pregnancy risk. It does not provide a framework for a truly integrated consultation, since the emphasis is on STIs and CSA. | N/A |
N/A Not applicable
CSA, child sexual abuse; DST, decision support tool; EHC, event history calendar; HCP, heathcare professional; HPV, human papillomavirus; IUC, intrauterine contraception; LARC, long-acting reversible contraception; MCT, My Contraception Tool; N/A, not applicable; SRH, sexual and reproductive healthcare; STI, sexually transmitted infection.