Feasibility and acceptability of a computer-based tool to improve contraceptive counseling

The objective was to test the feasibility and acceptability of a computerized tool, Smart Choices, designed to enhance the quality of contraceptive counseling in family planning clinics. The tool includes (a) a questionnaire completed by patients and summarized in a printout for providers and (b) a birth control guide patients explore to learn about various contraceptive methods.

In 2 family planning clinics, we conducted interviews with 125 women who used the Smart Choices computerized tool and 7 providers.

Smart Choices integrated into clinic flow well in one clinic, but less well in the other, which had very short waiting times. Patients were generally enthusiastic about Smart Choices, including its helpfulness in preparing them and their providers for the counseling session and increasing their knowledge of contraceptive methods. Providers varied in how much they used the printout and in their opinions about its usefulness. Some felt its usefulness was limited because it overlapped with the clinic's intake forms or because it did not match with their concept of counseling needs. Others felt it provided valuable information not collected by intake forms and more honest information. Some found Smart Choices to be most helpful with patients who were unsure what method they wanted.

Smart Choices is feasible to implement and well received by patients, but modifications are needed to increase provider enthusiasm for this tool.

The Smart Choices tool requires refinement before widespread dissemination.