Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, Saint Louis, MO 63110, USA.
Contraception. 2013 Aug;88(2):243-9. doi: 10.1016/j.contraception.2012.07.015. Epub 2012 Sep 5.
We describe the contraceptive counseling provided by the Contraceptive CHOICE Project (CHOICE) and compare contraceptive methods selected between the university research site and community partner clinics.
We developed a structured, contraceptive counseling program. All CHOICE participants enrolling at our university research site underwent the counseling, which was evidence-based and included information about all reversible contraception. Participants enrolling at partner clinics underwent "usual" counseling. We trained 54 research team members to provide contraceptive counseling; the majority had no formal health care training. We compared the contraceptive methods chosen by participants enrolling at our university research site to participants enrolling at partner clinics who did not undergo structured contraceptive counseling.
There were 6,530 (86%) women who enrolled into CHOICE at our university site and 1,107 (14%) women who enrolled at partner clinics. Uptake of long-acting reversible contraception was high at both the university site and partner clinics (72% and 78%, respectively, p<.0001). However, uptake of the intrauterine device was higher at the university site (58% compared to 43%, p<.0001) and uptake of the subdermal implant was higher at partner clinics (35% versus 14%, p<.0001). After adjusting for confounders, we found no difference in the uptake of long-acting reversible contraception between women counseled at the university site compared to partner clinics (adjusted relative risk=0.98, 95% confidence interval [0.94, 1.02]).
Structured contraceptive counseling can be effectively provided in a clinical research setting by staff without prior health care experience or clinical training.
我们描述了避孕选择项目（CHOICE）提供的避孕咨询，并比较了在大学研究点和社区合作伙伴诊所选择的避孕方法。
我们开发了一种结构化的避孕咨询方案。所有在我们大学研究点注册的 CHOICE 参与者都接受了咨询，该咨询基于证据，包括所有可逆避孕方法的信息。在合作伙伴诊所注册的参与者接受了“常规”咨询。我们培训了 54 名研究团队成员提供避孕咨询；大多数人没有接受过正规的医疗保健培训。我们比较了在我们大学研究点注册的参与者选择的避孕方法与在合作伙伴诊所注册但未接受结构化避孕咨询的参与者。
在我们的大学点有 6530 名（86%）女性参加了 CHOICE，有 1107 名（14%）女性在合作伙伴诊所参加了 CHOICE。长效可逆避孕措施在大学点和合作伙伴诊所的使用率都很高（分别为 72%和 78%，p<.0001）。然而，宫内节育器的使用率在大学点更高（58%比 43%，p<.0001），皮下埋植剂的使用率在合作伙伴诊所更高（35%比 14%，p<.0001）。在调整了混杂因素后，我们发现接受大学点咨询的女性与接受合作伙伴诊所咨询的女性在长效可逆避孕措施的使用率方面没有差异（调整后的相对风险=0.98，95%置信区间[0.94，1.02]）。
在没有先前医疗保健经验或临床培训的情况下，结构化的避孕咨询可以在临床研究环境中有效地提供。
