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Use of A Mobile Application for Contraceptive Decision Making: A Pragmatic Clinical Trial
Lori L Trego1, Angela K Phillips2, Taylor N Washington3
1College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
Introduction:
Unintended pregnancy (UIP) among service women despite universal coverage of reproductive health care is problematic. The Decide + Be Ready (D + BR) mobile app is a contraceptive decision aid designed to address the unique challenges of effective contraception in a military lifestyle. The purpose of this study is to determine the association between women's D + BR use and satisfaction with their contraceptive method, contraception adherence, and avoidance of unintended pregnancy. Additionally, we explored the characteristics of mobile app user engagement with D + BR.
Materials And Methods:
This pragmatic clinical trial evaluated the use of D + BR before contraceptive counseling in comparison to usual contraceptive care. Active duty (AD) women and spouses of AD service members who were scheduled for reproductive health care at a military treatment facility (intervention group [IG]) used D + BR before their contraceptive counseling visit. Those who had already received contraceptive counseling were enrolled in the comparative control group (CCG). All participants completed measures of satisfaction, adherence, and pregnancy. IG participants completed a survey assessing user-engagement with D + BR. Institutional approval was obtained by a DoD institutional review board.
Results:
Women in the IG (n = 33) who completed the 2-month postcounseling survey and CCG (n = 27) were satisfied with and highly adherent to their prescribed method, with nonsignificant differences between groups in satisfaction (P = .82) and adherence to prescribed method (P = .06). No pregnancies were reported in either group. IG participants were satisfied with using D + BR; they liked the app's content but found navigation challenging.
Conclusions:
Women avoided UIP with or without the D + BR app. Future research should evaluate and develop the design features of D + BR from a patient-centered approach and explore the association of D + BR use with shared decision-making. Results support continued development of the D + BR app for this unique population.
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