Background
Patient characteristics associated with adherence to dual method contraceptive use are not known.
Study Design
Project PROTECT was a 24-month long randomized trial designed to promote the use of dual methods of contraception using an individualized computer-based intervention or enhanced standard care counseling intervention. We analyzed 463 women with follow-up data and examined sustained dual method use (reported at 2+ interviews).
Results
While 32% initiated dual method contraceptive use, only 9% reported sustained use. Education increased (RRadj = 4.42; 95%CI 1.19-16.42), substance abuse decreased (RRadj = 0.49; 95%CI 0.24-0.97), no contraceptive use at baseline decreased (RRadj = 0.32; 95%CI 0.11-0.92), and contraceptive stage of change increased (RRadj =5.04; 95%CI 1.09-23.4) adherence to dual method use.
Conclusion
To effectively prevent sexually transmitted diseases (STIs) and unplanned pregnancies, dual method use must be consistent and sustained. Future interventions to promote dual method use should focus on high-risk groups and additional dual method combinations (e.g., barrier plus intrauterine devices or implants).
Although developing rapidly, maternal-fetal surgery research has yet to achieve the typical quality of studies and aggregate strength of evidence needed to optimally inform care.
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