Warren Alpert Medical School of Brown University, Women & Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA.
Warren Alpert Medical School of Brown University, Women & Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA; Rhode Island Department of Corrections, Medical Program Director, 39 Howard Avenue, Cranston, RI 02920, USA.
Contraception. 2020 May;101(5):327-332. doi: 10.1016/j.contraception.2020.01.004. Epub 2020 Jan 23.
Rates of unintended pregnancies in women with a history of incarceration are high and access to contraception before and after arrest can be limited. Individualized counseling can better prepare women for healthy pregnancy or provide an opportunity for contraceptive education and access within correctional facilities. In this study, we assessed the efficacy of motivational interviewing as an individualized intervention to increase the initiation of contraceptive methods while incarcerated and continuation after release in female inmates who wanted to avoid pregnancy for at least one year after release.
We performed an RCT in a population of incarcerated women who wanted to avoid pregnancy. Women were randomized to either a computer-assisted motivational interviewing intervention group (n = 119) or an educational video with counseling control group. (n = 113). The primary outcome was initiation of a method of birth control prior to release from the correctional facility.
Initiation of contraception was higher in the intervention group (56% vs. 42%, p = 0.03), but this difference was not significant after controlling for number of male partners within the year prior to incarceration. There was no difference between the groups in the rates of pregnancies or STIs or continuation of contraception after release, which was generally low (21%).
Computer-assisted motivational interviewing did not improve uptake or continuation of contraception in this study.
Periods of incarceration provide an opportunity to offer contraceptive services to women who want to avoid a pregnancy. Motivational interviewing may not be an effective method to affect contraceptive behaviors in this population. Future research should explore the family planning values and preferences of women who become involved with the correctional system.
有监禁史的女性意外怀孕率较高，且被捕前后获得避孕措施的机会可能受到限制。个性化咨询可以让女性更好地为健康妊娠做准备，或在监狱内提供避孕教育和获取避孕措施的机会。在这项研究中，我们评估了动机性访谈作为一种个体化干预措施的效果，该措施旨在增加希望在出狱后至少一年内避免怀孕的女性囚犯在监禁期间和出狱后开始使用避孕方法的比例。
我们在希望在出狱后至少一年内避免怀孕的监禁女性人群中进行了一项 RCT。女性被随机分配至计算机辅助动机性访谈干预组（n=119）或教育视频加咨询对照组（n=113）。主要结局是在离开惩教设施之前开始使用一种避孕方法。
干预组的避孕措施起始率更高（56%比 42%，p=0.03），但在控制入狱前一年内男性伴侣数量后，这一差异无统计学意义。两组在怀孕率或性传播感染率或出狱后继续避孕方面无差异，总体较低（21%）。
计算机辅助动机性访谈并未在这项研究中提高避孕措施的采用率或续用率。
监禁期间为希望避免怀孕的女性提供避孕服务的机会。动机性访谈可能不是影响该人群避孕行为的有效方法。未来的研究应探讨与惩教系统有关的女性的计划生育价值观和偏好。
