Motivational interviews to improve contraceptive use in populations at high risk of unintended pregnancy: a systematic review and meta-analysis

Wilson, Amie; Nirantharakumar, Krishnarajah; Truchanowicz, Ewa; Surenthirakumaran, Rajendra; MacArthur, Christine

doi:10.1016/j.ejogrb.2015.05.010

Cited by 22 publications

(13 citation statements)

References 24 publications

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“…Two reviews focused specifically on sexual health in gay men [ 84 , 85 ]. One review focused on the effectiveness of Motivational Interviewing on contraceptive use in women [ 87 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-nine reviews reported meta-analyses but it was not possible to extract data from all. [ 6 – 9 , 12 , 21 – 23 , 26 , 27 , 30 , 38 , 39 , 41 , 45 , 46 , 48 , 49 , 56 – 58 , 67 , 71 , 73 , 74 , 77 , 81 , 84 , 87 , 91 , 93 , 95 , 100 , 102 , 106 , 108 , 111 , 112 , 116 ]. Table 5 provides a brief summary of results from the reviews with pooled data comparisons.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews

et al. 2018

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BackgroundThe challenge of addressing unhealthy lifestyle choice is of global concern. Motivational Interviewing has been widely implemented to help people change their behaviour, but it is unclear for whom it is most beneficial. This overview aims to appraise and synthesise the review evidence for the effectiveness of Motivational Interviewing on health behaviour of adults in health and social care settings.MethodsA systematic review of reviews. Methods were pre-specified and documented in a protocol (PROSPERO–CRD42016049278). We systematically searched 7 electronic databases: CDSR; DARE; PROSPERO; MEDLINE; CINAHL; AMED and PsycINFO from 2000 to May 2018. Two reviewers applied pre-defined selection criteria, extracted data using TIDIER guidelines and assessed methodological quality using the ROBIS tool. We used GRADE criteria to rate the strength of the evidence for reviews including meta-analyses.FindingsSearches identified 5222 records. One hundred and four reviews, including 39 meta-analyses met the inclusion criteria. Most meta-analysis evidence was graded as low or very low (128/155). Moderate quality evidence for mainly short term (<6 months) statistically significant small beneficial effects of Motivational Interviewing were found in 11 of 155 (7%) of meta-analysis comparisons. These outcomes include reducing binge drinking, frequency and quantity of alcohol consumption, substance abuse in people with dependency or addiction, and increasing physical activity participation.ConclusionsWe have created a comprehensive map of reviews relating to Motivational Interviewing to signpost stakeholders to the best available evidence. More high quality research is needed to be confident about the effectiveness of Motivational Interviewing. We identified a large volume of low quality evidence and many areas of overlapping research. To avoid research waste, it is vital for researchers to be aware of existing research, and the implications arising from that research. In the case of Motivational Interviewing issues relating to monitoring and reporting fidelity of interventions need to be addressed.

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“…Two reviews focused specifically on sexual health in gay men [ 84 , 85 ]. One review focused on the effectiveness of Motivational Interviewing on contraceptive use in women [ 87 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews

et al. 2018

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“…The interview was based on WHO guidelines and communication tools [21,26]. Sessions were structured according to social cognitive theory, based in motivational interviewing [14,22,23,27,28] and followed a guide with key components communicated to all participants. The intervention was culturally adapted in accordance with the results of a broad formative investigation.…”

Section: Methodsmentioning

confidence: 99%

Impact of a community contraceptive counselling intervention on adolescent fertility rates: a quasi-experimental study

et al. 2020

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Background: From 2000 to 2008, in urban areas in Spain, adolescent fertility and abortion rates underwent unprecedented increases, consecutive to intensive immigration from developing countries. To address unmet needs for contraception information and services, a community-based, gender-sensitive and culturally adapted brief counselling intervention (SIRIAN program) was launched in some deprived neighbourhoods with a high proportion of immigrants in Barcelona. Once a randomized controlled trial demonstrated its effectiveness in increasing the use of contraceptives, we aim to examine its population impact on adolescent fertility rates. Methods: Quasi-experimental study with comparison group, using population data from 2005 to 2016. Five neighbourhoods in the lowest tercile of Disposable Household Income were intervened in 2011-13. The comparison group included the three neighbourhoods which were in the same municipal district and in the lowest Disposable Household Income tercile, and displayed the highest adolescent fertility rates. Generalized linear models were fitted to assess absolute adolescent fertility rates and adjusted by immigrant population between pre-intervention (2005-10) and post-intervention periods (2011-16); Difference in Differences and relative pre-post changes analysis were performed. Results: In 2005-10 the intervention group adolescent fertility rate was 27.90 (per 1000 women 15-19) and 21.84 in the comparison group. In 2011-16 intervention areas experienced great declines (adolescent fertility rate change: − 12.30 (− 12.45 to − 12.21); p < 0.001), while comparison neighbourhoods remained unchanged (adolescent fertility rate change: 1.91 (− 2.25 to 6.07); p = 0.368). A reduction of − 10.97 points (− 13.91 to − 8.03); p < 0.001) is associated to the intervention. Conclusion: Adolescent fertility rate significantly declined in the intervention group but remained stable in the comparison group. This quasi-experimental study provide evidence that, in a country with universal health coverage, a community counselling intervention that increases access to contraception, knowledge and sexual health care in hard-to-reach segments of the population can contribute to substantially reduce adolescent fertility rates. Reducing adolescent fertility rates could become a feasible goal in cities with similar conditions.

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“…Women who hail culturally from, for example, Latin America, The Caribbean, Suriname, India, Thailand, Iran, Cape Verde, South-Africa, Turkey, North America or China, where PC for a completed family is well-established [ 1 ], might be reluctant even anxious to use (some of) the unfamiliar, i.e., never used by their mothers and peers, reversible methods entrenched and popular elsewhere, costs are also a factor [ 10 , 14 , 50 , 56 , 57 , 65 – 69 ]. Moreover, the continuous motivation and discipline needed for injections, condoms and pills are a problem for many [ 14 , 70 , 71 ]. Alas it is very easy for women to find support for their anxieties on the internet.…”

Section: Increasing Cultural Diversificationmentioning

confidence: 99%

Recent developments have made female permanent contraception an increasingly attractive option, and pregnant women in particular ought to be counselled about it

Verkuyl

2016

Contracept Reprod Med

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BackgroundDespite the increased prevalence of reversible contraception, global unintended pregnancy rates are stable. Mistakes, method failures, side effects, alcohol, stock-outs, fears, costs, delays, myths, religious interference, doctors with other priorities, traditions and lack of health professionals may all factor in. Yet these unintended pregnancies ― nearly a hundred million annually ― cause much individual suffering, and in the long run, can aggravate conflicts, poverty, forced emigration and climate change. Presently, non-poor women postpone childbearing because of longer educational trajectories and careers. Sterilisations are therefore less often regretted or coerced. For poor-resourced women with a completed family, an unwanted pregnancy often has serious consequences, including crossing the (extreme) poverty line in the wrong direction, choosing an unsafe abortion, or even death. Caesarean sections (CSs), which currently stand at around 23 million annually, are increasing. On an “intention-never-to-become-pregnant-again” analysis, choosing a partial, and even more so a total bilateral tubectomy to be implemented during an ― anyway performed ― CS is by far the most reliable and safe contraceptive choice compared to meaning to start female or male sterilisation or any other contraceptive method later, and it reduces the chance of a future ovarian carcinoma substantially. CSs make subsequent pregnancies more dangerous. Simultaneously, they provide convenient, potentially cost-free opportunities for voluntary permanent contraception (PC): particularly important if there is no guaranteed future access to reliable contraception, safe abortion and well-supervised labour.Partial solutionMillions of women are within reach of attaining freedom from the “tyranny of excessive fertility” when they have a CS. Therefore, any woman who might conceivably be of the firm opinion that her family will be (over) completed after delivery should antenatally have “what if you have a CS” counselling to assess whether she would like a tubectomy/ligation. Yet many are not provided with this option: leading to frequent regret, more often than having been giving that choice would.ConclusionWithholding antenatal counselling about the option of PC for in case the delivery might become a CS is very prevalent, yet often more medically risky, and morally questionable than when, even in labour, a doctor sometimes decides in the absence of earlier counselling, considering numerous factors, to provide the choice to undergo a concurrent sterilisation if s/he is convinced that would be in the patient’s best interest.

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Motivational interviews to improve contraceptive use in populations at high risk of unintended pregnancy: a systematic review and meta-analysis

Abstract: Motivational interviews significantly increase effective contraceptive use immediately after and up to four months post-intervention. The effect without reinforcement is short lasting as no evidence of effect is seen after four months post-intervention.

Cited by 22 publications

References 24 publications

Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews

Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews

Impact of a community contraceptive counselling intervention on adolescent fertility rates: a quasi-experimental study

Recent developments have made female permanent contraception an increasingly attractive option, and pregnant women in particular ought to be counselled about it

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