Although reproductive life planning (RLP) is recommended in federal and clinical guidelines and may help insured women make personalized contraceptive choices, it has not been systematically evaluated for effectiveness.
In 2014, some 984 privately insured women aged 18–40 who were not intending to become pregnant in the next year were randomly assigned to receive RLP, RLP with contraceptive action planning (RLP+) or information only (the control group). Women's contraceptive use, prescription contraceptive use, method adherence, switching to a more effective method, method satisfaction and contraceptive self‐efficacy were assessed at six‐month intervals during the two‐year follow‐up period. Differences between groups were identified using binomial logistic regression, linear regression and generalized estimating equation models.
During the follow‐up period, the proportion of women using any contraceptive method increased from 89% to 96%, and the proportion using a long‐acting reversible contraceptive or sterilization increased from 8% to 19%. Contraceptive adherence was high (72–76%) in all three groups. In regression models, the sole significant finding was that women in the RLP+ group were more likely than those in the RLP group to use a prescription method (odds ratio, 1.3). No differences were evident between the intervention groups and the control group in overall contraceptive use, contraceptive adherence, switching to a more effective method, method satisfaction or contraceptive self‐efficacy.
The study does not provide evidence that web‐based RLP influences contraceptive behaviors in insured women outside of the clinical setting. Further research is needed to identify strategies to help women of reproductive age identify contraceptive methods that meet their needs and preferences.
Cynthia H. Chuang and Christopher N. Sciamanna are professors, Departments of Medicine and Public Health Sciences; Carol S. Weisman is distinguished professor, Departments of Public Health Sciences and Obstetrics and Gynecology; Diana L. Velott is senior instructor, Erik Lehman is research data analyst and Vernon M. Chinchilli is distinguished professor, Department of Public Health Sciences; Erica B. Francis is patient partner; and Richard S. Legro is professor, Department of Obstetrics and Gynecology—all at Penn State College of Medicine, Hershey, PA. Merry-K. Moos is an independent consultant. Christopher J. Armitage is professor, Department of Health Psychology, University of Manchester, Manchester, UK.