Nurse family partnership contraceptive study

Our session will describe the preliminary results of a five year, five site randomized clinical trial of adding a contraceptive dispensing component to the Nurse Family Partnership (NFP) home visiting program. The NFP program provides home visits for first-time pregnant women and their children, continuing for two years after their children are born. Participant inclusion criteria included English or Spanish speaking, enrolled in the NFP program and 32 weeks or less gestation. We randomized participants to receive either usual NFP care or an enhanced NFP intervention that included hormonal contraceptive administration and distribution. Participants in the enhanced intervention received a choice of combination oral contraceptives, progestin-only oral contraceptives, the contraceptive patch, the contraceptive vaginal ring or a depomedroxyprogesterone injection at no cost. The study had 4 aims: 1)Determine whether participants in the enhanced intervention group experienced fewer gaps in effective contraceptive use (defined as methods with which < 10% of women experience an accidental pregnancy during a year of typical use) compared to participants in the usual care group; 2)Examine whether fewer participants in the enhanced intervention group experienced a second pregnancy compared to participants in the usual care group; 3)Explore how pregnancy intendedness modifies the Aim 1 and Aim 2 outcomes; 4) Determine whether women receiving contraceptives at home were more or less likely to receive sexually transmitted infection screening and treatment than women who receive these services in a clinic setting (usual care group). If effective, the intervention could significantly reduce the burdens and complications of unintended pregnancy.