Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
Am J Obstet Gynecol. 2015 Mar;212(3):310.e1-7. doi: 10.1016/j.ajog.2014.09.027. Epub 2014 Sep 28.
Adoption of long-acting reversible contraception (LARC) (ie, the intrauterine device or the contraceptive implant) immediately after abortion is associated with high contraceptive satisfaction and reduced rates of repeat abortion. Theory-based counseling interventions have been demonstrated to improve a variety of health behaviors; data on theory-based counseling interventions for postabortion contraception are lacking.
Informed by the transtheoretical model of behavioral change, a video intervention was developed to increase awareness of, and dispel misconceptions about, LARC methods. The intervention was evaluated in a randomized controlled trial among women aged 18-29 years undergoing surgical abortion at a clinic in Chicago, IL. Participants were randomized 1:1 to watch the intervention video or to watch a stress management video (control), both 7 minutes in duration. Contraceptive methods were supplied to all participants free of charge. Rates of LARC initiation immediately after abortion were compared.
Rates of LARC initiation immediately after abortion were not significantly different between the 2 study arms; 59.6% in the intervention and 51.6% in the control arm chose a LARC method (P = .27).
This study resulted in an unexpectedly high rate of LARC initiation immediately after abortion. High rates of LARC initiation could not be attributed to a theory-based counseling intervention.
在流产后立即采用长效可逆避孕措施（LARC）（即宫内节育器或避孕植入物）与较高的避孕满意度和较低的重复流产率相关。基于理论的咨询干预措施已被证明可以改善各种健康行为；缺乏关于流产后避孕基于理论的咨询干预措施的数据。
受行为变化跨理论模型的启发，开发了一个视频干预措施，以提高对 LARC 方法的认识并消除对其的误解。该干预措施在伊利诺伊州芝加哥一家诊所接受手术流产的 18-29 岁女性中进行了随机对照试验评估。参与者按照 1:1 的比例随机分配观看干预视频或观看 7 分钟的应激管理视频（对照组）。为所有参与者免费提供避孕方法。比较流产后立即开始使用 LARC 的比率。
两组研究组中流产后立即开始使用 LARC 的比率没有显著差异；干预组中有 59.6%的人选择了 LARC 方法，对照组中有 51.6%的人选择了 LARC 方法（P=.27）。
本研究导致流产后立即开始使用 LARC 的比率出乎意料地高。高比率的 LARC 起始不能归因于基于理论的咨询干预措施。
