The 130th Annual Meeting of APHA

Abstract #48194

Jennifer M. Ballentine, MPH¹, Ruth Petersen, MD, MPH², Richard Boise, MD³, Annette Aalborg, PhD⁴, Kathryn M Curtis, PhD⁵, and Rebecca Cabral, PhD¹. (1) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, Mailstop K-34, Atlanta, GA 30341, 770-488-6231, JBallentine@cdc.gov, (2) Sheps Center for Health Services Research, University of North Carolina, CB#7590, 725 Airport Road, Chapel Hill, NC 27599-7590, (3) Adolescent Medicine, The Permanente Medical Group, 3400 Delta Fair Blvd, Antioch, CA 94509, (4) Division of Research, Kaiser Permanente, 3505 Broadway, Oakland, CA 94611, (5) Division of Reproductive Health., CDC, MS K-34 4770 Buford Highway, NE, Atlanta, GA 30341

Objective: To describe the process of developing and implementing a clinic-based, risk-reduction counseling intervention designed to address unintended pregnancy and HIV/STD infection.

Methods: Based on a review of behavioral theories and interventions that have been applied to sexual risk-taking behaviors, we developed a stage-tailored, multi-faceted reproductive health counseling intervention consisting of: 1) a self-administered reproductive health risk assessment tool containing items designed to measure self-efficacy and stage of change for contraceptive use, 2) a semi-structured one-on-one, stage-tailored counseling session using motivational interviewing techniques and 3) a booster telephone call designed to reinforce counseling messages. To test the feasibility of implementing this intervention and translating behavioral theory into practice, we conducted a pilot study with 85 women seeking pregnancy testing in a managed care setting.

Results: The intervention was feasible to implement; 94.1% of women reported that the counseling was useful. However, measurement and implementation issues surfaced when developing and applying the intervention. Specifically, the items designed to measure self-efficacy and stage of change proved difficult to use in practice and inapplicable to some of the target audience. The quality of the counselor training and the content of the counseling sessions needed to be more rigorously evaluated to determine appropriate application of theory.

Conclusions: Much valuable information was learned from the process of developing and implementing the clinic-based, risk-reduction counseling intervention. Recommended next steps include adapting the intervention based on lessons learned and evaluating the intervention in a randomized, controlled clinical trial.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Describe the components of a unique clinic-based counseling intervention to reduce unintended pregnancy and STD/HIV infection;
• List three lessons learned from the process of developing and implementing this intervention;
• Discuss how this intervention can be adapted based on lessons learned and applied in clinical settings to improve counseling addressing unintended pregnancy, HIV and STDs.

Keywords: Reproductive Health, Intervention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.