The 130th Annual Meeting of APHA

3199.0: Monday, November 11, 2002 - Board 4

Abstract #45407

Reproductive Health Counseling at Pregnancy Testing—Feasibility of Implementation

Richard Boise, MD, MPH1, Ruth Petersen, MD, MPH2, Kathryn M Curtis, PhD3, Annette Aalborg, PhD4, Cathleen K Yoshida, MS4, Rebecca Cabral, PhD5, and Jennifer Ballentine, MPH5. (1) Adolescent Medicine, The Permanente Medical Group, 3400 Delta Fair Blvd, Antioch, CA 94509, 925-779-5136, richard.boise@kp.org, (2) Sheps Center for Health Services Research, University of North Carolina, CB#7590, 725 Airport Road, Chapel Hill, NC 27599-7590, (3) Division of Reproductive Health., CDC, MS K-34 4770 Buford Highway, NE, Atlanta, GA 30341, (4) Division of Research, Kaiser Permanente, 3505 Broadway, Oakland, CA 94611, (5) Division of Reproductive Health, Centers for Disease Control and Prevention, Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341

Context: To examine feasibility of implementing brief reproductive health counseling for women not desiring pregnancy and obtaining a pregnancy test in a managed care setting.

Methods: Participants were women ages 18-44 years, who requested a pregnancy test and did not wish to be pregnant. Participants completed a self-assessment of contraceptive and STD risk behavior. Counselors provided motivational counseling and access to contraception. The participant and counselor negotiated next steps to reduce the participant’s risk. Two weeks later, the counselor called the participant to reinforce counseling. At follow-up, interviewers asked participants about completion of next steps, behavioral changes, and intervention satisfaction.

Results: Eighty-five women completed counseling; 58 (68%) completed follow-up. Participants were young (mean 25 years), co-habitating (69%), and racially/ethnically diverse (Latina 38%, African American 27%). Thirty-four percent reported highly effective use of contraception. Participants reported that the counseling was useful (94%) at baseline (94%) and at follow-up (83%). The staff found the intervention important (100%) and implementation feasible (100%). Next steps were entirely completed by 59% and partially completed by 28%. Forty-one percent of participants moved from no or less effective use of contraception to more effective use, while 29% continued highly effective use, and 9% moved “backwards” in effective use. Of 22 participants with STD risk, 3 (14%) began using condoms consistently, while 1 (5%) continued using condoms consistently.

Conclusions: Counseling at pregnancy testing in a managed care setting was feasible to implement. Observed behavior changes suggest that this intervention may be effective in increasing effective use of contraception.

Learning Objectives: Learning Objectives