Contraception
Conditions
Keywords
randomized control trial; contraception; inequalities
Brief summary
This study evaluates the effects of a community-based counseling intervention to improve contraception among residents in two deprived neighborhoods in Barcelona (Spain). Half of the participants received contraceptive counseling at the community setting, while the other half acted as a control group.
Detailed description
To evaluate the effects of a community-based counseling intervention to improve contraception among residents in deprived neighborhoods a randomized controlled trial is performed. Women aged 14-49 years and men aged 14-39 years from two low income neighborhoods in Barcelona (Catalonia, Spain) who had not undergone an irreversible contraceptive method and aren't planning a pregnancy have been recruited in 2011-13. The intervention consists of a culturally developed and theoretically-based brief counseling in community settings. The primary outcome is the consistent use of very effective contraceptive methods (optimal use). Secondary outcomes analyzed are the incorrect use of very effective contraceptive methods and use of less effective methods stratified by sex and migrant status. Differences within subgroups from baseline to 3 months - follow up are analyzed and intervention effects are assessed with adjusted robust Poisson regressions.
Interventions
BEHAVIORALContraceptive counseling
A culturally adapted counselling session lasting up to 45 minutes at the community setting. The interview is based in WHO guidelines and communication tools, in social cognitive theory and in motivational interviewing. Along the interview, topics follow easy to read leaflets prepared to discuss the main benefits of contraception from the view of the immigrant communities, with guided discussions on family planning in the life course, the amount of time required to care children, the economic resources that newborn and children need, and an assessment of the knowledge on the contraceptive methods, and of their current use. Contraceptive methods, abortion and emergency contraception are discussed. Primary health care centre and sexual and reproductive health clinic access is reinforced.
Sponsors
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
14 Years to 49 Years
Healthy volunteers
Yes
Inclusion criteria
* Women living in the selected neighbourhoods aged 14-49 years * Men living in the selected neighbourhoods aged 14-39 years
Exclusion criteria
* Having undergone an irreversible contraceptive method * Whishing or planning a pregnancy in the next year
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants using consistently effective contraceptive methods (optimal use) assessed by questionnaire | Three months after the baseline | Primary outcome is the consistent use of effective methods. Effective methods include female sterilization, vasectomy, tube obstruction, IUD, implants, oral contraception, rings, patches, injections and female and male condoms |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants inconsistently using effective methods assessed by questionnaire | Three months after the baseline | Inconsistent use of effective methods: Condoms used in some intercourse episodes and not others, condoms used improperly, taking birth control pills but missing too many doses for pregnancy prevention |
| Number of participants using less effective methods (withdrawal and periodic abstinence) assessed by questionnaire | Three months after the baseline | Use of less effective methods (withdrawal and periodic abstinence). Practices such as douching are not considered a contraceptive method |
Countries
Spain
Outcome results
None listed