调整:使用在线避孕决策帮助妇女提高生殖自我效能和知识;实验性临床试验的结果

Summer Mengelkoch, Matthew Espinosa, Stephen A. Butler, Laura Joigneau Prieto, Emma Russell, Chris Ramshaw, Shardi Nahavandi, Sarah E. Hill
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摘要

数字辅助决策在医疗保健的许多领域正变得越来越普遍。这些辅助工具旨在让患者参与医疗决策,目的是改善患者的治疗效果,同时减轻医疗负担。人们发现,以前开发的以避孕药具为基础的决策辅助工具在提高妇女对生殖健康和避孕的知识方面很有效。在这里,我们试图评估一种新型的基于避孕药的决策辅助在提高妇女的自我效能感和对其生殖健康和避孕选择的认识以及她们对自己学习的看法方面的有效性。该研究已于2022年5月1日在ClinicalTrials.gov注册为临床试验(避孕决策辅助使用和患者结局,ID# NCT05177783)。方法通过对324名妇女进行tunune®避孕辅助决策器和对照组决策器的试验,评价tunune®避孕辅助决策器的有效性。主要结果包括生殖健康自我效能、生殖健康和避孕知识以及学习感知。二次分析检验了先前使用激素避孕药的经验是否调节了决策辅助和每个结果测量之间的关系。结果使用Tuune®决策辅助工具的妇女表现出更高的生殖健康自我效能感,对生殖健康和避孕有更多的了解,并认为比使用对照组决策辅助工具的妇女学到了更多(p s≤0.029)。在既往使用过避孕药具的妇女中也观察到这种模式,使用Tuune®的妇女报告的结果优于使用对照药物的妇女,无论她们的激素避孕药使用史如何,尽管这种相互作用并不显著(p = 0.089)。结论:使用tune®基于避孕药的辅助决策改善了每一个预测结果相对于控制决策援助。这表明,使用Tuune®基于避孕药的决策辅助工具可以很好地提高妇女对避孕药具使用的信心和知识,也可以减轻卫生保健系统的负担。
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Tuuned in: use of an online contraceptive decision aid for women increases reproductive self-efficacy and knowledge; results of an experimental clinical trial
Abstract Background Digital decision aids are becoming increasingly common in many areas of healthcare. These aids are designed to involve patients in medical decision making, with the aim of improving patient outcomes while decreasing healthcare burden. Previously developed contraceptive-based decision aids have been found to be effective at increasing women’s knowledge about reproductive health and contraception. Here, we sought to evaluate the effectiveness of a novel contraceptive-based decision aid at increasing women’s self-efficacy and knowledge about their reproductive health and contraceptive options, as well as their perceptions of their learning. This study was registered as a clinic trial at ClinicalTrials.gov (Contraception Decision Aid Use and Patient Outcomes, ID# NCT05177783) on 05/01/2022. Methods The Tuune® contraceptive decision aid’s effectiveness was evaluated by conducting an experiment in which 324 women were assigned to use the Tuune® decision aid or a control decision aid. Primary outcomes included reproductive health self-efficacy, reproductive health and contraceptive knowledge, and perceptions of learning. Secondary analyses examined whether prior experience using hormonal contraceptives moderated the relationship between decision aid and each outcome measure. Results Women assigned to use the Tuune® decision aid exhibited greater reproductive health self-efficacy, greater knowledge about reproductive health and contraception, and perceived having learned more than women assigned to use the control decision aid ( p s ≤ .029). This pattern was also observed in women with previous contraceptive use experience, where women using Tuune® reported better outcomes than women using the control aid, regardless of their history of hormonal contraceptive use experience, although this interaction was not significant ( p = .089). Conclusions Use of the Tuune® contraceptive-based decision aid improved each of the predicted outcomes relative to a control decision aid. This suggests that use of the Tuune® contraceptive-based decision aid is well poised to increase women’s confidence and knowledge about contraceptive use and may also reduce burden on healthcare systems.
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