Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104812

Ruth Petersen, MD, MPH¹, Jennifer Albright, MPH², Hayley Holland, MPH², Patricia Payne, CNM, MPH³, Valerie King, MD, MPH⁴, and Kathryn M. Curtis, PhD⁵. (1) Department of Obstetrics and Gynecology and Center for Women's Health Research, University of North Carolina, CB # 7521, 725 Airport Road, Chapel Hill, NC 27599-7521, 919-966-7924, ruth_petersen@unc.edu, (2) Sheps Center for Health Services Research, University of NC, CB # 7521, Chapel Hill, NC 27599-7521, (3) School of Nursing, East Carolina University, Rivers RW309, Greenville, NC 27858, (4) Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-7591, (5) National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K34, Atlanta, GA 30341

Objectives: To evaluate a behavioral-based, contraceptive counseling intervention administered by health educators.

Method: Randomized controlled trial of 747 women at risk of unintended pregnancy enrolled from March 2003 to September 2004 at primary health care settings. Intervention participants received individualized counseling, using a modification of motivational interviewing, to address barriers to effective and consistent contraceptive use and other sexual risk-taking behaviors. Risk reduction steps were negotiated. Pregnancy, Chlamydia, and behavioral outcomes were assessed.

Results: At baseline, 79% of participants did not want to be pregnant and 21% were unsure about whether or not they wanted to be pregnant. Baseline contraceptive use included: oral contraceptives (37%); condoms (36%); withdrawal, fertility awareness, or emergency contraception (16%); IUD, Depo-Provera or Norplant (12%); and other (8%). When examining contraceptive use by effectiveness and consistency, 59% of participants reported highly effective use; 19%, less effective use; and 21%, no method use. Intervention participants (n= 363) reported barriers to contraceptive use and selected risk reduction steps within 5 categories including: continue current method, increase consistency of method, start or re-start a method, obtain medical follow-up, or think about starting a method. At the 2-month follow-up, completion rates of steps, by category, were 90%, 66%, 75%, 47%, 81% respectively.

Discussion: Despite a lack of desire for pregnancy, over 40% of women did not report highly effective method use. Women reported barriers to contraceptive use but were willing to negotiate risk reduction steps. Differences between the study arms at 12-months will illustrate the potential influence of the intervention.

Learning Objectives: