Using a reproductive life planning website and action plan to help women choose and use birth control
BACKGROUND: Unintended pregnancies occur when no contraception is used, is used inconsistently, or contraceptive failure occurs. In August 2012, the Affordable Care Act (ACA) required most private insurers cover FDA-approved contraceptive methods without cost-sharing. Without cost barriers, privatel...
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| Format: | eBook |
| Language: | English |
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[Washington, D.C.]
Patient-Centered Outcomes Research Institute
[2019], 2019
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| Series: | Final research report
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | BACKGROUND: Unintended pregnancies occur when no contraception is used, is used inconsistently, or contraceptive failure occurs. In August 2012, the Affordable Care Act (ACA) required most private insurers cover FDA-approved contraceptive methods without cost-sharing. Without cost barriers, privately insured women may be well positioned to respond to interventions designed to assist them with individualized contraceptive decision making. Potential interventions include reproductive life planning (RLP) and contraceptive action planning. Recommended by the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG), RLP involves setting goals for having or not having children and making a plan to achieve those goals. Contraceptive action planning guides users to identify solutions ahead of time for challenges commonly encountered when using contraception. The primary outcomes were proportion of the study period that women self-reported any contraceptive use, prescription contraceptive use, and high method adherence when at risk for unintended pregnancy, as well as the switch to a more-effective contraceptive method by the end of the study. Secondary outcomes included self-reported method satisfaction and contraceptive self-efficacy. We compared the longitudinal outcome measures by the study group using binomial logistic regression. RESULTS: The MyNewOptions trial randomized 984 women between April and July 2014. The proportion of the study period that women in the control, RLP, or RLP+ group were at risk for unintended pregnancy and using any method (95%, 94%, and 95%, respectively; P = .15), a prescription method (64%, 61%, 65%, respectively; P = .03), or reported high adherence (76%, 73%, 72%, respectively; P = .99) did not differ by group allocation. The proportion of the study period in which women were highly satisfied with their method (58% control, 58% RLP, 57% RLP+; P = .86) and had high contraceptive self-efficacy also did not differ by group allocation. Switching to a more-effective method during the study also did not differ by study group (24% control, 26% RLP, 24% RLP+; P = .85). Contraceptive use and long-acting reversible contraceptive use increased significantly from 88.5% and 8.4% at baseline to 95.8% and 19.4% at 2 years, respectively, but we observed no differences by group allocation. CONCLUSIONS: Our results suggest that a web-based reproductive life planning tool may not result in privately insured women using more-effective contraceptive methods. Whether web-based RLP or contraceptive action planning affects, contraceptive use has not been evaluated in controlled trials. OBJECTIVES: The MyNewOptions study was a randomized trial designed to test whether web-based RLP alone or in combination with contraceptive action planning (RLP+) affects patient-centered contraceptive outcomes in insured women. METHODS: We invited insured women residing in Pennsylvania, 18 to 40 years of age, and not intending pregnancy in the next year to join MyNewOptions, a fully online study. After completing a baseline survey, women were randomized to 1 of 3 arms: RLP; RLP+; or an information-only control group. Women completed follow-up surveys and revisited the study website every 6 months during the 24-month study. LIMITATIONS AND SUBPOPULATION CONSIDERATIONS: The null findings may be due to lack of intervention intensity, the web-based intervention format, an unintended intervention effect of the control condition, or a ceiling effect in our well-educated, privately insured sample. We also observed no intervention effects in post hoc stratified analyses by age group (<26 years and ≥26 years) |
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| Physical Description: | 1 PDF file (93 pages) illustrations |