This study is testing models of contraceptive care that were developed as part of the Contraceptive CHOICE Project. CHOICE is a prospective cohort study of 9,256 women designed to: 1) promote the use of long-acting reversible contraceptive (LARC) methods which include interuterine devices (IUD) and subdermal implants; 2) remove financial barriers to contraception; 3) evaluate continuation of and satisfaction with reversible methods; and 4) reduce unintended pregnancies in the St. Louis region. CHOICE demonstrated that interventions such as comprehensive contraceptive counseling, increased access, and removal of financial barriers increase the uptake of LARC methods and reduce unintended pregnancy. The investigators objective is to determine whether the CHOICE model of contraceptive care can be equally successful in the real world of community clinics.
This project involves comparing two models of contraceptive care; 'enhanced care' which is usual care plus the CHOICE structured contraceptive counseling, and the 'complete CHOICE' group which includes the structured contraceptive counseling as well as provider training and cost support for IUDs and implants. Participants will be enrolled at three partner community clinics by a staff member (site coordinator) dedicated to the research study. All participants will undergo contraceptive counseling as well as a baseline survey with the coordinator. Participants will complete telephone surveys at 3, 6, and 12 months post-enrollment and will be asked about contraceptive method chosen, satisfaction and continuation of the method, and any pregnancies experienced since enrollment.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
1,008
Women in both phases of the study will receive the structured contraceptive counseling developed by the Contraceptive CHOICE Project.
Prior to Phase 2, health care providers at the recruitment sites will undergo a contraceptive education session with a focus on evidence-based provision of contraception including LARC (IUDs and implant) and same-day insertion.
Women in Phase 2 of the study who desire an IUD or implant can receive one through the study at no cost if they do not have insurance coverage. If women have insurance that covers the device, her insurance will be billed for the cost of the device.
Family Care Health Center Forest Park
St Louis, Missouri, United States
Family Care Health Center Carondelet
St Louis, Missouri, United States
Memphis Health Center
Memphis, Tennessee, United States
Unintended Pregnancy
The number of self-reported unintended pregnancies.
Time frame: 12 months
Contraceptive Method Use Upon Enrollment Completion
This measure indicates the contraceptive method that the patient left with after the clinical visit on the day of enrollment. Patients could have received desired new method, received a bridge method, stayed on current method, or received no method.
Time frame: On the day of enrollment
Desired Contraceptive Method at Enrollment Visit
This could be a new method, an existing method, or nothing if participant did not choose a method
Time frame: On the day of enrollment
Participants Choosing Long-Acting Reversible Contraception (LARC) at Enrollment Visit
Number of women choosing an IUD or implant as their preferred contraceptive method
Time frame: On the day of enrollment
Same Day LARC Insertion
Of the participants who chose LARC as their preferred method, the number who received the device the same day as their enrollment visit.
Time frame: On the day of enrollment
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