Integration of a Comprehensive Contraception Education Program Into Clinical Practice in a Family Planning Clinic

To improve rates of contraception adherence by implementing a comprehensive contraception educational program for women receiving care at a family planning clinic.

Quasi-experimental cohort study in which we evaluated women presenting before (control group) and after program implementation (intervention group) and compared the proportion of women returning for contraceptive method change and/or for unintended pregnancy.

Family planning clinic of a large academic medical center.

English-speaking women ages 12 to 50 years who presented to the clinic for pregnancy termination or initiation of a new contraceptive method from May 2012 to May 2014.

A provider-facilitated, patient-centered educational intervention was implemented to foster patient knowledge and choice about contraception.

We conducted chart review to identify any clinic visit that occurred in the 12 months after the index visit. Pearson's chi-square test was used to compare results for women in both groups. The intervention group included 201 women, and the control group included 162 women. In the control group, 28% (n = 46/162) returned within the year for unintended pregnancy and/or contraceptive method change, whereas only 17% (n = 35/201) returned in the study group. This difference was statistically significant (p < .05).

Initiation of a comprehensive contraception educational program was associated with a decrease in rates of return visits for unintended pregnancy and contraceptive method changes. This implies an improvement in adherence to the initially chosen contraceptive method. Such interventions hold promise for improving contraceptive adherence and decreasing unintended pregnancy. Improving contraceptive adherence is a critical first step to decreasing unintended pregnancies.