141st APHA Annual Meeting

In This section

277389
Nurse family partnership contraceptive study

Tuesday, November 5, 2013 : 11:35 AM - 11:50 AM

Alan Melnick, MD, MPH, CPH , Clark County Public Health, Vancouver, WA
Marni Storey, RN, MS , Clark County Public Health, Vancouver, WA
Elizabeth Jacob-Files, MA , Family Medicine, Oregon Health Science University, Portland, OR
Miguel Marino, PhD , Department of Family Medicine, Oregon Health and Science University, Portland, OR
Rebecca Rdesinski, MSW, MPH , Department of Family Medicine, Oregon Health & Science University, Portland, OR
Teresa Gipson, MD, MPH , Department of Family Medicine, Oregon Health &Science University, Portland, OR
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.

Learning Areas:
Provision of health care to the public
Public health administration or related administration
Public health or related nursing

Learning Objectives:
Describe an intervention involving distribution of contraceptives to women at home through the Nurse Family Partnership home visiting program. Evaluate the effectiveness of the intervention in reducing gaps in effective contraceptive use and in reducing unintended pregnancy. Discuss barriers and facilitators associated with the effectiveness of the intervention Describe how the intervention could be implemented elsewhere.

Keywords: Contraception, Home Visiting

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator on two randomized clinical trials, one federally funded, focusing on the provision of contraceptives through public health nursing home visits. Among my scientific interests are the development and evaluation of community based interventions through partnerships between academic centers and local public health departments.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.