NCT02364037

Brief Summary

This study is testing models of contraceptive care that were developed as part of the Contraceptive CHOICE Project. CHOICE is a prospective cohort study of 9,256 women designed to: 1) promote the use of long-acting reversible contraceptive (LARC) methods which include interuterine devices (IUD) and subdermal implants; 2) remove financial barriers to contraception; 3) evaluate continuation of and satisfaction with reversible methods; and 4) reduce unintended pregnancies in the St. Louis region. CHOICE demonstrated that interventions such as comprehensive contraceptive counseling, increased access, and removal of financial barriers increase the uptake of LARC methods and reduce unintended pregnancy. The investigators objective is to determine whether the CHOICE model of contraceptive care can be equally successful in the real world of community clinics.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,008

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Aug 2013

Longer than P75 for not_applicable

Geographic Reach
1 country

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

August 1, 2013

Completed
1.5 years until next milestone

First Submitted

Initial submission to the registry

February 9, 2015

Completed
7 days until next milestone

First Posted

Study publicly available on registry

February 16, 2015

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2017

Completed
10 months until next milestone

Study Completion

Last participant's last visit for all outcomes

October 31, 2017

Completed
11 months until next milestone

Results Posted

Study results publicly available

October 3, 2018

Completed
Last Updated

June 2, 2020

Status Verified

May 1, 2020

Enrollment Period

3.4 years

First QC Date

February 9, 2015

Results QC Date

October 26, 2017

Last Update Submit

May 26, 2020

Conditions

Keywords

intrauterine devicesubdermal implantcontraceptive counseling

Outcome Measures

Primary Outcomes (1)

  • Unintended Pregnancy

    The number of self-reported unintended pregnancies.

    12 months

Secondary Outcomes (4)

  • Contraceptive Method Use Upon Enrollment Completion

    On the day of enrollment

  • Desired Contraceptive Method at Enrollment Visit

    On the day of enrollment

  • Participants Choosing Long-Acting Reversible Contraception (LARC) at Enrollment Visit

    On the day of enrollment

  • Same Day LARC Insertion

    On the day of enrollment

Study Arms (2)

Phase 1: Enhanced Care

OTHER

Women in Phase 1 of the prospective study will receive the CHOICE Project structured contraceptive counseling in addition to usual care by their health care provider. Contraceptive coverage will be by the usual mechanism such as insurance or financial assistance programs.

Behavioral: CHOICE Project Structured Contraceptive Counseling

Phase 2: Complete CHOICE

OTHER

Women in Phase 2 of the prospective study (Complete CHOICE) will receive the CHOICE Project structured contraceptive counseling. Immediately prior to the start of Phase 2, health care providers in participating health centers will undergo a contraceptive education session with a focus on evidence-based guideline for LARC provision and same-day insertion. Participating women will receive cost support for IUDs and implants if she chooses either as her contraceptive method and does not have appropriate insurance coverage.

Behavioral: CHOICE Project Structured Contraceptive CounselingBehavioral: Contraceptive Education SessionDevice: Cost Support for IUDs and implants

Interventions

Women in both phases of the study will receive the structured contraceptive counseling developed by the Contraceptive CHOICE Project.

Phase 1: Enhanced CarePhase 2: Complete CHOICE

Prior to Phase 2, health care providers at the recruitment sites will undergo a contraceptive education session with a focus on evidence-based provision of contraception including LARC (IUDs and implant) and same-day insertion.

Phase 2: Complete CHOICE

Women in Phase 2 of the study who desire an IUD or implant can receive one through the study at no cost if they do not have insurance coverage. If women have insurance that covers the device, her insurance will be billed for the cost of the device.

Phase 2: Complete CHOICE

Eligibility Criteria

Age14 Years - 45 Years
Sexfemale
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • years of age
  • Does not desire pregnancy during the next 12 months
  • Desires reversible contraception
  • Sexually active with a man within the past 6 months or intend to have sex with a man in the next 3 months
  • Willing and able to undergo informed consent
  • Willing to comply with study protocol and 1-year follow-up schedule
  • Not currently pregnant
  • Current patient at Family Care Carondelet, Family Care Forest Park Southeast, Memphis Health Center

You may not qualify if:

  • Has undergone a female sterilization procedure such as tubal ligation or hysterectomy
  • Has one sexual partner who has undergone a vasectomy procedure
  • Speaks language other than English or Spanish
  • Currently using an IUD or implant as her contraceptive method

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Family Care Health Center Forest Park

St Louis, Missouri, 63110, United States

Location

Family Care Health Center Carondelet

St Louis, Missouri, 63111, United States

Location

Memphis Health Center

Memphis, Tennessee, 38126, United States

Location

Related Publications (2)

  • Madden T, Paul R, Maddipati R, Buckel C, Goodman M, Peipert JF. Comparison of unintended pregnancy at 12 months between two contraceptive care programs; a controlled time-trend design. Contraception. 2019 Sep;100(3):196-201. doi: 10.1016/j.contraception.2019.05.009. Epub 2019 May 24.

  • Buckel C, Maddipati R, Goodman M, Peipert JF, Madden T. Effect of staff training and cost support on provision of long-acting reversible contraception in community health centers. Contraception. 2019 Apr;99(4):222-227. doi: 10.1016/j.contraception.2018.12.005. Epub 2019 Jan 24.

MeSH Terms

Interventions

Intrauterine Devices

Intervention Hierarchy (Ancestors)

Contraceptive Devices, FemaleContraceptive DevicesEquipment and Supplies

Results Point of Contact

Title
Rachel Paul
Organization
Washington University School of Medicine

Study Officials

  • Tessa Madden, MD/MPH

    Washington University School of Medicine

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Masking Details
Due to the controlled time-trend design and, therefore, the different time periods for enrollment and follow up for each group, we were unable to mask the research and clinical staff who administered surveys to the study group assignment when collecting data regarding the study outcomes.
Purpose
PREVENTION
Intervention Model
SEQUENTIAL
Model Details: We used a prospective, controlled time-trend study design, a non-randomized design where outcomes are compared before and after a change in the healthcare setting.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 9, 2015

First Posted

February 16, 2015

Study Start

August 1, 2013

Primary Completion

January 1, 2017

Study Completion

October 31, 2017

Last Updated

June 2, 2020

Results First Posted

October 3, 2018

Record last verified: 2020-05

Locations