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Calling all high-risk patients: Can a simple telephone call increase contraception continuation after abortion?

Jody Steinauer, University of California San Francisco, 2010
See also executive summary.

Project abstract

Goal: To evaluate the efficacy of a six-week telephone call to problem-solve with women who chose combined hormonal contraception (CHC) after abortion in order to increase continuation.

Specific aims: (1) To determine use of effective contraception at six weeks after abortion in women who receive an educational and problem-solving phone call at three weeks compared to women who do not receive the intervention. (2) To describe the most common concerns and logistical problems women experience with adhering to combined hormonal contraception after their abortions. (3) To assess feasibility of conducting follow-up telephone calls in this population.

Background: Approximately 40% of the patients at the San Francisco General Hospital Women's Options Center (WOC) choose CHCs as their post-abortion contraception, with an estimated 60 prescribed each month. Unfortunately, combined hormonal methods (CHC) are associated with high failure rates, and women undergoing abortion are at especially high risk of poor contraceptive use and repeat unintended pregnancy. In one study of women at the WOC only 70% of women who chose the combined oral contraceptive had filled their prescription the second month after their abortion.

Methods: This is a randomized, controlled trial to assess the effect of a three-week follow-up phone call in women who choose CHC at the time of their abortion at the WOC at San Francisco General Hospital. Eligible subjects are all women who speak English or Spanish who choose CHC as their post-abortion contraception. Women will receive a phone call and will have the opportunity to have a trained health educator answer questions regarding their new contraceptive method and to problem-solve with them about its use. Their questions will be recorded, as well as logistical aspects of the phone calls. The primary outcome is use of any contraceptive method with an efficacy of 92% or greater at two months.

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