Evaluation of an Intervention to Increase Post-abortion LARC Uptake.

Emory University1,314 enrolled

Overview

This is a randomized prospective study evaluating the impact of a brief contraceptive education intervention with optional referral for financial counseling on post abortion long-acting reversible contraceptive (LARC) uptake and contraceptive use at three months post abortion.

As repeat unintended pregnancy and abortion remain public health challenges, increasing long-acting reversible contraceptive (LARC), specifically intrauterine device (IUD) and contraceptive implant, use among women presenting for abortion care is a priority. Despite its efficacy and safety, LARC methods remain underutilized in the abortion setting. This is a randomized prospective study evaluating the impact of a brief contraceptive education intervention with optional referral for financial counseling on post abortion long-acting reversible contraceptive (LARC) uptake and contraceptive use at three months post abortion.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

1,314

Conditions

Post Abortion Contraception

Interventions

Contraceptive education prior to abortionBEHAVIORAL

Contraceptive education script will be delivered over the phone prior to abortion visit.

Eligibility

Sex: FEMALEMin age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Women calling to schedule an appointment for an abortion and/or those who receive abortion services at the Atlanta Women's Center with fluency in English and able to provide informed consent * 16 years and older Exclusion Criteria: -Younger than 16 years old

Locations (1)

Atlanta Women's Center

Atlanta, Georgia, United States

Outcomes

Primary Outcomes

Proportion of Long-Acting Reversible Contraception (LARC) methods inserted immediately post abortion in the intervention and standard of care arms.

Proportion of LARC methods inserted immediately post abortion in the intervention and standard of care arms will be calculated based on data abstracted from patients' medical records.

Time frame: Immidiately post abortion (day of the procedure).

Secondary Outcomes

Proportion of Long-Acting Reversible Contraception (LARC) methods used in the intervention and standard of care arms three months post abortion.

This outcome is inclusive of immediate initiators and those who initiate by three months. Proportion of LARC methods used in the intervention and standard of care arms will be calculated based on the 3-month follow-up phone interview.

Time frame: Three months post abortion.

Cost-effectiveness analysis of the study intervention.

The cost-effectiveness analysis will involve multiple parts. The study team will initially complete a cost description of the interventions involving time spent in developing the scripts for LARC education and financial counseling, and additional time spent making contact with women and providing the augmented counseling compared to the initial pre-communication session.Incremental cost-effectiveness ratios for the intervention overall will be calculated compared to a 'base-case' of standard of care in the primary analysis. This value will provide cost per additional women using LARC. In a secondary analysis, the study team will compare differences between women receiving the educational component only versus 'base-case', and also women receiving the educational and financial counseling component versus 'base-case'.

Time frame: Three months post abortion.

Data from ClinicalTrials.gov

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