Contraceptive Usage, Contraception Behavior
Conditions
Brief summary
A randomized trial comparing LARC uptake and satisfaction after either video or conversational-based contraceptive counseling for pregnant women in labor.
Detailed description
This was a multi-center randomized, controlled trial examining contraceptive counseling in the setting of long-acting reversible contraception (LARC) uptake and immediate provision. At two urban public hospitals with large adolescent populations, participants were randomized to a structured, in-person conversation with a trained counselor or a 14-minute video providing the same information. Both participant groups were provided written materials and both had the opportunity to ask questions of the counselor. The total time to complete counseling was measured, as well as participant satisfaction, pre- and post-intervention contraceptive knowledge, and intended postpartum contraceptive method.
Interventions
OTHERVideo counseling
Video counseling
OTHERConversational counseling
Conversational counseling
Sponsors
Universidad de Antioquia
Oregon Health and Science University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Two groups randomized to counseling type.
Eligibility
Sex/Gender
FEMALE
Age
14 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Live pregnancy \>20 weeks gestation * Admission to maternity ward for labor * Age \>14
Exclusion criteria
* Pain \>=8 on Wong-Baker FACES pain scale
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total Counseling Time | Immediately following the intervention, an average of less than 30 minutes | Duration of counseling in minutes (from initiation of counseling to conclusion of all questions answered.) The clock was not stopped for breaks, which were allowed as needed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knowledge Scores | One hour | Mean total correct answer (score) to 7 multiple-choice contraceptive knowledge questions. Total possible score is 0-7, with 7 representing 100% correct answers. Score measured after completion of the knowledge questionnaire, on average less than one hour, before (pre) and after (post) counseling. |
| Number of Participants Initiating Postpartum LARC Uptake | Assessed at the time of hospital discharge, on average less than 2 days | Number of participants initiating long-acting reversible contraception (LARC - intrauterine device (IUD) or implant) prior to hospital discharge. |
Countries
Colombia
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Video Counseling The video group watched a 13.75 minute video of a local Colombian counselor reading a script of the same information provided by conversational counseling and had a chance to ask questions at the end.
Video counseling: Video counseling | 120 |
| Conversational Counseling The conversation group participated in a structured, face-to-face conversation with a trained counselor.
Conversational counseling: Conversational counseling | 119 |
| Total | 239 |
Baseline characteristics
| Characteristic | Conversational Counseling | Total | Video Counseling |
|---|---|---|---|
| Age, Categorical <=18 years | 23 Participants | 43 Participants | 20 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 96 Participants | 196 Participants | 100 Participants |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment Colombia | 119 participants | 239 participants | 120 participants |
| Sex: Female, Male Female | 119 Participants | 239 Participants | 120 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 120 | 0 / 119 |
| other Total, other adverse events | 0 / 120 | 0 / 119 |
| serious Total, serious adverse events | 0 / 120 | 0 / 119 |
Outcome results
Primary
Total Counseling Time
Duration of counseling in minutes (from initiation of counseling to conclusion of all questions answered.) The clock was not stopped for breaks, which were allowed as needed.
Time frame: Immediately following the intervention, an average of less than 30 minutes
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Video Counseling | Total Counseling Time | 16.8 minutes | Standard Deviation 4.6 |
| Conversational Counseling | Total Counseling Time | 16.3 minutes | Standard Deviation 4.6 |
Secondary
Knowledge Scores
Mean total correct answer (score) to 7 multiple-choice contraceptive knowledge questions. Total possible score is 0-7, with 7 representing 100% correct answers. Score measured after completion of the knowledge questionnaire, on average less than one hour, before (pre) and after (post) counseling.
Time frame: One hour
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Video Counseling | Knowledge Scores | Pre-counseling | 3.1 score on a scale | Standard Deviation 1.5 |
| Video Counseling | Knowledge Scores | Post-counseling | 5.3 score on a scale | Standard Deviation 1 |
| Conversational Counseling | Knowledge Scores | Pre-counseling | 3.1 score on a scale | Standard Deviation 1.5 |
| Conversational Counseling | Knowledge Scores | Post-counseling | 5.1 score on a scale | Standard Deviation 1.2 |
Secondary
Number of Participants Initiating Postpartum LARC Uptake
Number of participants initiating long-acting reversible contraception (LARC - intrauterine device (IUD) or implant) prior to hospital discharge.
Time frame: Assessed at the time of hospital discharge, on average less than 2 days
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Video Counseling | Number of Participants Initiating Postpartum LARC Uptake | 46 Participants |
| Conversational Counseling | Number of Participants Initiating Postpartum LARC Uptake | 44 Participants |