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Theory-based strategies for improving contraceptive use: a systematic review
Laureen M Lopez1, Elizabeth E Tolley, David A Grimes
1Family Health International, Research Triangle Park, NC 27709, USA. llopez@fhi.org
Contraception
|May 16, 2009
Summary
Theory-based interventions show mixed results for improving contraceptive use and preventing HIV/STIs. More consistent application of single behavior change theories and detailed reporting are needed for better outcomes.
Area of Science:
- Behavioral Science
- Public Health
- Reproductive Health
Background:
- Behavior change theories and models provide frameworks for understanding how individuals alter their actions.
- Systematic reviews of randomized controlled trials are crucial for evaluating the efficacy of interventions.
Purpose of the Study:
- To systematically review randomized controlled trials evaluating theory-based interventions for improving contraceptive use.
- To assess the effectiveness of these interventions on outcomes such as pregnancy, general contraceptive use, and condom use for HIV/STI prevention.
Main Methods:
- Searched electronic databases for relevant randomized controlled trials.
- Extracted data on primary outcomes including pregnancy and contraceptive use.
- Calculated odds ratios for dichotomous data and mean differences for continuous data.
Main Results:
- Ten of fourteen included trials demonstrated positive effects for theory-based interventions.
- Positive effects were observed in 2/10 studies for pregnancy/birth outcomes, 4/9 for general contraceptive use, and 5/9 for condom use (HIV/STI prevention).
- Interventions based on Social Cognitive Theory showed favorable results in six of seven trials, with other models and motivational interviewing also showing some success, primarily in adolescent populations.
Conclusions:
- The effectiveness of theory-based interventions for contraceptive use is not consistent across all outcomes and comparisons.
- The field would benefit from more focused application of individual behavior change theories.
- Improved reporting on the implementation details of interventions is necessary for future research and practice.
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