Bommaraju Aalap, Malat Jennifer, Mooney Jennifer L
Department of Sociology, University of Cincinnati, Cincinnati, Ohio; Cincinnati-Hamilton County Reproductive Health and Wellness Program, Cincinnati, Ohio.
Department of Sociology, University of Cincinnati, Cincinnati, Ohio; Kunz Center for Social Research, University of Cincinnati, Cincinnati, Ohio.
Womens Health Issues. 2015 May-Jun;25(3):209-15. doi: 10.1016/j.whi.2015.02.005.
Although the Centers for Disease Control and Prevention and the U.S. Office of Population Affairs recommend inclusion of reproductive life plan counseling (RLPC) in all well-woman health care visits, no studies have examined the effect of RLPC sessions on the decision to use effective contraception at publicly funded family planning sites. RLPC could be a particularly impactful intervention for disadvantaged social groups who are less likely to use the most effective contraceptive methods.
Using data from 771 nonpregnant, non-pregnancy-seeking women receiving gynecological services in the Cincinnati-Hamilton County Reproductive Health and Wellness Program, multinomial logistic regression models compared users of nonmedical/no method with users of 1) the pill, patch, or ring, 2) depot medroxyprogesterone acetate, and 3) long-acting reversible contraception (LARC). The effect of RLPC on the use of each form of contraception, and whether it mediated the effect of race/ethnicity and education on contraceptive use, was examined while controlling for age, insurance status, and birth history. The interaction between RLPC and race/ethnicity and the interaction between RLPC and educational attainment was also assessed.
RLPC was not associated with contraceptive use. The data suggested that RLPC may increase LARC use over nonmedical/no method use. RLPC did not mediate or moderate the effect of race/ethnicity or educational attainment on contraceptive use in any comparison.
In this system of publicly funded family planning clinics, RLPC seems not to encourage effective method use, providing no support for the efficacy of the RLPC intervention. The results suggest that this intervention requires further development and evaluation.
尽管美国疾病控制与预防中心以及美国人口事务办公室建议在所有女性健康检查中纳入生殖生活计划咨询（RLPC），但尚无研究探讨RLPC课程对在公共资助的计划生育机构使用有效避孕措施的决策的影响。对于不太可能使用最有效避孕方法的弱势社会群体而言，RLPC可能是一项特别有影响力的干预措施。
利用来自辛辛那提 - 汉密尔顿县生殖健康与健康项目中接受妇科服务的771名未怀孕、非寻求怀孕的女性的数据，多项逻辑回归模型将非医疗/未采取任何方法的使用者与以下使用者进行了比较：1）口服避孕药、避孕贴片或阴道避孕环；2）醋酸甲羟孕酮长效避孕针；3）长效可逆避孕法（LARC）。在控制年龄、保险状况和生育史的同时，研究了RLPC对每种避孕方式使用的影响，以及它是否介导了种族/民族和教育程度对避孕使用的影响。还评估了RLPC与种族/民族之间的相互作用以及RLPC与教育程度之间的相互作用。
RLPC与避孕措施的使用无关。数据表明，与非医疗/未采取任何方法相比，RLPC可能会增加LARC的使用。在任何比较中，RLPC均未介导或调节种族/民族或教育程度对避孕使用的影响。
在这个由公共资金资助的计划生育诊所系统中，RLPC似乎并未鼓励使用有效方法，无法为RLPC干预措施的有效性提供支持。结果表明，这种干预措施需要进一步发展和评估。
