Improving Adolescent Adherence to Hormonal Contraception
Project Number: R40 MC 06634-04 Project Date: 01/01/2006 Grantee: University of Texas Medical Branch Department/Center: Dept of OB/GYN School of Medicine
Final Report
Pending
Principal Investigator
Abbey B. Berenson M.D., Professor, University of Texas Medical Branch Dept of OB/GYN School of Medicine, 301 University Blvd. Galveston, TX 77555-0587 abberens@utmb.edu
Abstract
Many adolescents who obtain oral contraception from a health care facility become pregnant within 1 year because they do not take their pills for more than a few months. To reduce the number of unintended pregnancies among these young women, programs must be developed and tested that increase the number of adolescents who use effective contraception for an extended period of time. To address this critical need, a multisite, randomized, controlled trial will be conducted that examines the effectiveness of two different interventions on adolescent adherence with oral contraception during the first 12 months of use. In addition, the effect of these interventions on rates of dual use (oral contraception and condoms) will be evaluated. A total of 1,400 adolescents from 16 to 24 years of age who request oral contraception at one of three family planning clinics will be recruited to participate. Adolescents will receive either (1) a clinic-based intervention consisting of face-to-face behavioral counseling and education at the time of the baseline clinic visit; (2) this same clinic-based intervention followed by monthly booster phone calls for the first 6 months that the adolescent uses her new method; or (3) usual care. Phone interviews conducted 3, 6 and 12 months after the baseline visit will assess contraceptive and condom use as well as method satisfaction. Furthermore, clinic records will be reviewed to determine unintended pregnancy rates, attendance at a 3-month follow-up clinic visit for a new supply of contraception, and the results of gonorrhea and chlamydia cultures. Statistical models will be used to evaluate the effect of the interventions (relative to usual care) on contraceptive adherence and dual use of condoms, while adjusting for age and contraceptive method. Secondary analyses will examine the roles of health literacy and pregnancy intentions on contraceptive adherence. If either of these interventions proves successful, this study could make a major difference in the lives of numerous women by decreasing the number who experience an unintended pregnancy or contract a sexually transmitted disease during adolescence.
Publications
Pending
Keywords
adolescent pregnancy prevention, patient education, sexually transmitted diseases, university affiliated programs, low income population, family planning, compliance, minority groups.
