American Journal of Obstetrics & Gynecology
Volume 195, Issue 1 , Pages 85-91, July 2006

Communicating contraceptive effectiveness: A randomized controlled trial to inform a World Health Organization family planning handbook

  • Markus J. Steiner, PhD

      Affiliations

    • Family Health International, Research Triangle Park, NC
    • Corresponding Author InformationReprint requests: Markus Steiner, PhD, Family Health International, PO Box 13950, Research Triangle Park, NC 27709.
    • ,
  • James Trussell, PhD

      Affiliations

    • Office of Population Research, Princeton University, Princeton, NJ
    • ,
  • Neha Mehta, MPH

      Affiliations

    • Family Health International, Research Triangle Park, NC
    • ,
  • Sean Condon, DrPH

      Affiliations

    • Family Health International, Research Triangle Park, NC
    • ,
  • Sumathi Subramaniam, MPH

      Affiliations

    • Independent Consultant, Bangalore, India
    • ,
  • Deborah Bourne, MA

      Affiliations

    • Hope Enterprises Ltd, Kingston, Jamaica

Received 1 September 2005; received in revised form 19 December 2005; accepted 22 December 2005. published online 21 April 2006.

Objective

The objective of the study was to compare 3 different approaches for increasing clients' understanding of contraceptive effectiveness.

Study design

We randomized 900 reproductive-age women in India and Jamaica to 1 of 3 charts presenting pregnancy risk.

Results

The most important reason for choosing a contraceptive was how well it prevents pregnancy (54%) followed by few side effects (17%). At baseline, knowledge about contraceptive effectiveness was poor. About half knew oral contraceptive pills are more effective than condoms (46%) and intrauterine devices are more effective than injectables (50%). All 3 charts improved knowledge significantly (P < .01) for these 2 questions. No chart improved knowledge better than any other (P > .05). The chart ranking contraceptive methods on a continuum was judged slightly easier to understand than the other 2 charts.

Conclusion

Only with accurate understanding of pregnancy risk can clients make informed choices. Our results have already informed a global handbook for family planning providers to use the chart ranking contraceptive methods on a continuum.

Key words: Contraception, Contraceptive counseling, Informed choice, Decision aids

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 Supported by the William and Flora Hewlett Foundation.

PII: S0002-9378(05)02752-3

doi:10.1016/j.ajog.2005.12.053

American Journal of Obstetrics & Gynecology
Volume 195, Issue 1 , Pages 85-91, July 2006

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