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Development and testing of a computerized contraceptive decision-making tool

Gina Secura, Washington University in St. Louis School of Medicine, 2009
See also executive summary.

Project abstract

Contraceptive counseling is an important component of contraceptive decision-making, however little data exists on how to most effectively counsel patients. Patient decision aids have been successfully employed in other areas of healthcare decision-making and have been shown to result in increased knowledge, more realistic expectations, and decreased decisional conflict.

In this innovative study, we propose to conduct the formative research to develop a computerized decision aid to assist patients with contraceptive decision-making. This tool will incorporate social and cultural factors that influence women’s contraceptive decisions with the goal of increasing contraceptive knowledge, satisfaction, and decision certainty.

We plan to use a mixed-methods approach to determine the importance and frequency of social and cultural factors in contraceptive decision-making. We will conduct focus groups with 50 women at high-risk for unintended pregnancy to initially identify social and cultural themes important in contraceptive decision-making. We will create and administer a written questionnaire to 250 women to determine the importance and frequency of these themes among a cohort of women seeking contraception.

We will use the results of the questionnaire to develop a computerized contraceptive decision tool that will incorporate social and cultural factors and prior medical, obstetric, gynecologic, and contraceptive history to assist the patient with contraceptive-decision making. Lastly, we will conduct a pilot randomized controlled trial and randomize women to the computerized contraceptive decision tool and standard clinical contraceptive counseling to evaluate the computerized decision aid and determine the feasibility of conducting a larger randomized controlled trial.

This project will utilize the resources of an established research team already successfully conducting a large study of contraceptive continuation and satisfaction. This study will also benefit from the large cohort of women seeking contraception who are being prospectively enrolled in this already funded study.

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