Evidence map›Paper›PMID 31132346›Full record

ArticleContraception2019

Comparison of unintended pregnancy at 12 months between two contraceptive care programs; a controlled time-trend design.

Tessa Madden, Rachel Paul, Ragini Maddipati, Christina Buckel, Melody Goodman, Jeffrey F Peipert

Open access · greenAbstract readComparative StudyControlled Clinical TrialMulticenter Study
In one paragraph

Article in Contraception, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Tessa MaddenDivision of Family Planning, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, 4901 Forest Park Avenue, Mailstop: 8064-37-1005, St. Louis, MO 63108, USA. Electronic address: maddent@wustl.edu.
Rachel PaulDivision of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, 4901 Forest Park Avenue, Mailstop: 8064-37-1005, St. Louis, MO 63108, USA.
Ragini MaddipatiDivision of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, 4901 Forest Park Avenue, Mailstop: 8064-37-1005, St. Louis, MO 63108, USA.
Christina BuckelDivision of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, 4901 Forest Park Avenue, Mailstop: 8064-37-1005, St. Louis, MO 63108, USA.
Melody GoodmanCollege of Global Public Health, New York University, 715 Broadway, 10th Floor, New York, NY 10003, USA.
Jeffrey F PeipertDepartment of Obstetrics and Gynecology, 550 University Blvd, University Hospital 2440, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Washington University in St. Louis · USIndiana University School of MedicineNew York University · US

Funding

EVALUATION AND TESTING OF A DECISION SUPPORT AID IN CONTRACEPTIVE DECISION MAKINGK23HD070979 · NICHD · WASHINGTON UNIVERSITY · PI MADDEN, TESSA · 2012 to 2014
$367k
NICHD NIH HHS K23 HD070979
6 · The paper itself

Abstract

objectivesTo compare unintended pregnancy rates at 12 months between women receiving structured contraceptive counseling plus usual contraceptive care and women receiving structured contraceptive counseling, healthcare provider education and cost support for long-acting reversible contraceptive (LARC) methods. STUDY

designUsing a controlled time-trend study design, we first enrolled 502 women receiving structured contraceptive counseling in addition to usual care ("Enhanced Care") and subsequently enrolled 506 women receiving counseling plus healthcare provider education and cost support for LARC methods ("Complete CHOICE") at three federally qualified health centers (FQHCs). Cost support included funds to health centers for "on-the-shelf" LARC methods and no-cost LARC methods for uninsured women. Participants completed in-person baseline surveys and follow-up surveys by telephone at 3, 6 and 12 months. We used Kaplan-Meier survival function to estimate 12-month unintended pregnancy rates and Cox proportional-hazards regression to compare unintended pregnancy rates between the two groups. We imputed pregnancy outcomes for women lost to follow-up (9%) prior to 12 months.

results"Complete CHOICE" participants were less likely to report an unintended pregnancy at 12 months compared to "Enhanced Care"; 5.3 vs. 9.8 pregnancies per 100 women-years (p=.01). After adjusting for confounders (recruitment site, race, age and federal poverty level), women in "Complete CHOICE" had a 40% lower risk of unintended pregnancy at 12 months (adjusted hazard ratio 0.60; 95% confidence interval 0.37-0.99).

conclusionsContraceptive provision that includes cost support and healthcare provider education in addition to patient counseling reduced unintended pregnancy at 12 months compared to counseling plus usual contraceptive care. IMPLICATIONS: A program of contraceptive care that includes comprehensive counseling; healthcare provider education; cost support; and on-the-shelf, long-acting reversible contraception can reduce unintended pregnancy compared to contraceptive counseling in addition to usual health center care in the FQHC setting.

Indexed as

Pregnancy, UnplannedProgram EvaluationAdolescentAdultContraceptionContraception BehaviorCounselingFamily Planning ServicesFemaleHumansKaplan-Meier EstimateLong-Acting Reversible ContraceptionMedically UninsuredMiddle AgedPregnancyPregnancy RateContraceptive counselingContraceptive implantIntrauterine deviceLong-acting reversible contraceptionUnintended pregnancy

Identifiers

PMID31132346
PMCPMC6699922
OpenAlexW2946213872

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.