私人保险妇女的生殖生活计划和避孕行动计划:MyNewOptions研究。

IF 3.4 2区 医学 Q1 DEMOGRAPHY Perspectives on Sexual and Reproductive Health Pub Date : 2019-12-01 Epub Date: 2019-12-09 DOI:10.1363/psrh.12123
Cynthia H Chuang, Carol S Weisman, Diana L Velott, Erik Lehman, Vernon M Chinchilli, Erica B Francis, Merry-K Moos, Christopher N Sciamanna, Christopher J Armitage, Richard S Legro
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引用次数: 2

摘要

背景:尽管生殖生活计划(RLP)在联邦和临床指南中被推荐,并可能帮助参保妇女做出个性化的避孕选择,但其有效性尚未得到系统的评估。方法:2014年将984名18-40岁不打算明年怀孕的私保女性随机分为RLP组、RLP+避孕行动计划组和仅提供信息组(对照组)。在两年的随访期间,每隔六个月对妇女的避孕药具使用情况、处方避孕药具使用情况、方法依从性、改用更有效的方法、方法满意度和避孕自我效能进行评估。使用二项逻辑回归、线性回归和广义估计方程模型来识别组间差异。结果:随访期间,妇女使用任何避孕方法的比例从89%增加到96%,使用长效可逆避孕或绝育的比例从8%增加到19%。所有三组的避孕依从性都很高(72-76%)。在回归模型中,唯一有意义的发现是RLP+组的女性比RLP组的女性更有可能使用处方方法(优势比,1.3)。干预组与对照组在总体避孕使用、避孕依从性、转向更有效的方法、方法满意度或避孕自我效能方面无明显差异。结论:该研究没有提供证据表明基于网络的RLP会影响参保妇女在临床环境之外的避孕行为。需要进一步研究以确定帮助育龄妇女确定满足其需要和偏好的避孕方法的战略。
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Reproductive Life Planning and Contraceptive Action Planning for Privately Insured Women: The MyNewOptions Study.

Context: Although reproductive life planning (RLP) is recommended in federal and clinical guidelines and may help insured women make personalized contraceptive choices, it has not been systematically evaluated for effectiveness.

Methods: In 2014, some 984 privately insured women aged 18-40 who were not intending to become pregnant in the next year were randomly assigned to receive RLP, RLP with contraceptive action planning (RLP+) or information only (the control group). Women's contraceptive use, prescription contraceptive use, method adherence, switching to a more effective method, method satisfaction and contraceptive self-efficacy were assessed at six-month intervals during the two-year follow-up period. Differences between groups were identified using binomial logistic regression, linear regression and generalized estimating equation models.

Results: During the follow-up period, the proportion of women using any contraceptive method increased from 89% to 96%, and the proportion using a long-acting reversible contraceptive or sterilization increased from 8% to 19%. Contraceptive adherence was high (72-76%) in all three groups. In regression models, the sole significant finding was that women in the RLP+ group were more likely than those in the RLP group to use a prescription method (odds ratio, 1.3). No differences were evident between the intervention groups and the control group in overall contraceptive use, contraceptive adherence, switching to a more effective method, method satisfaction or contraceptive self-efficacy.

Conclusions: The study does not provide evidence that web-based RLP influences contraceptive behaviors in insured women outside of the clinical setting. Further research is needed to identify strategies to help women of reproductive age identify contraceptive methods that meet their needs and preferences.

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来源期刊
CiteScore
5.10
自引率
3.40%
发文量
24
期刊介绍: Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.
期刊最新文献
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