Computer-assisted provision of emergency contraception a randomized controlled trial

Abstract

BACKGROUND: Emergency contraception (EC) can prevent unintended pregnancy. However, many women continue to lack information needed to use EC effectively and clinician time to counsel women about EC is limited. OBJECTIVE: To evaluate whether computer-assisted provision of EC can increase knowledge and use of EC among women able to access EC without a prescription. DESIGN: We conducted a randomized controlled trial in which the intervention group received a 15-minute computerized educational session and 1 pack of EC. The control group received education about periconception folate supplementation, but no information about EC. Participants were contacted 7 months after enrollment. PARTICIPANTS: Four hundred forty-six women recruited from 2 urgent care clinics in San Francisco in 2005. MEASUREMENTS: Knowledge of EC, use of EC, and self-reported pregnancy. RESULTS: At follow-up, women in the intervention group answered an average of 2 more questions about EC correctly than they had at baseline, whereas women in the control group answered only 1 more item correctly (2.0 vs 1.2, p < .001). There was a trend toward more use of EC during the study period in the intervention group (10% vs 4% of women followed, p = .06; 6% vs 3%, p = .09 of women enrolled). Fewer women in the intervention group were pregnant at the time of follow-up (0.8% vs 6.5%, p = .01 of women followed; 0.5% vs 4.0%, p = .01 of women enrolled). CONCLUSIONS: Computer-assisted provision of EC in urgent care waiting areas increased knowledge of EC in a state where EC had been available without a prescription for 3 years. © 2008 Society of General Internal Medicine.