Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes...

Area of Science:

• Reproductive Health Decision-Making
• Genetic Counseling
• Sickle Cell Disease (SCD) and Trait (SCT)

Background:

• Interventions for reproductive health decision-making in sickle cell disease (SCD) or trait (SCT) populations have limited long-term efficacy.
• Effective strategies are needed to support informed reproductive choices for individuals with SCD/SCT.

Purpose of the Study:

• To compare the efficacy of a web-based multimedia program (CHOICES) versus usual care (e-Book) in improving reproductive knowledge, intention, and behavior over 24 months.
• To assess the impact of the CHOICES program on partner selection to mitigate the risk of children inheriting SCD.

Main Methods:

• A randomized controlled trial involving 234 participants (SCD/SCT, ages 18-35, 94% African American) assigned to either the CHOICES program or an e-Book.
• Participants completed a sickle cell-specific reproductive measure at baseline and at 6, 12, 18, and 24 months post-intervention.
• Statistical analyses compared changes in knowledge, intention, and behavior between the two groups.

Main Results:

• The CHOICES group demonstrated significantly greater improvement in reproductive knowledge compared to the e-Book group (p=.004).
• No significant differences were observed in reproductive intention (p=.18) or behavior (p=.69) between the groups over 24 months.
• A higher proportion of participants in the CHOICES group selected partners that reduced the risk of their children inheriting SCD by the final visit (p=.04).

Conclusions:

• The CHOICES web-based program effectively enhances reproductive health knowledge in individuals with SCD/SCT.
• The intervention shows promise in influencing partner selection to reduce genetic risk for offspring, warranting further investigation in a national trial.
• Future research should focus on optimizing interventions for sustained behavioral change in reproductive decision-making for at-risk populations.