scholarly journals Effect of pregnancy tests on demand for family planning: evidence from a randomized controlled trial in Uganda

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Akito Kamei ◽  
Ryoko Sato ◽  
Rebecca Thornton
Keyword(s):  
Randomized Controlled Trial ◽  
Family Planning ◽  
Controlled Trial ◽  
Baseline Survey ◽  
Pregnancy Test ◽  
Randomized Controlled ◽  
Test Kit ◽  
Modern Family ◽  
Pregnancy Status ◽  
Modern Family Planning

Abstract Background Unmet need for family planning and unintended pregnancies are high in developing countries. Home pregnancy tests help women determine their pregnancy status earlier and the confirmation of a negative pregnancy status can facilitate the adoption of family planning. This study provides the first experimental evidence of the effect of access to pregnancy tests on women’s demand for modern family planning. Methods A randomized controlled trial was conducted among 810 women of reproductive age in northern Uganda. During a baseline survey, women were randomly allocated to either: (1) an offer to take a hCG urine pregnancy test during the survey (on-the-spot pregnancy test) (N = 170), (2) an offer of a home pregnancy test kit to be used at any time in the future (future-use pregnancy test) (N = 163), (3) offers of both on-the-spot and future-use pregnancy tests (N = 153), or (4) a control group (N = 324). Future-use pregnancy tests were offered either for free, or randomly assigned prices. Approximately 4 weeks after the baseline survey, a follow-up survey was conducted; modern contraception methods were made available at no charge at local community outreach centers. Results When offered a free, on-the-spot pregnancy test, 62 percent of women accepted (N = 200). Almost all, 97 percent (N = 69), of women offered a free future-use pregnancy test strip, accepted it. Purchases of future-use pregnancy tests declined with price. The offer of either on-the-spot, future-use tests, or both, have no overall large or statistically significant effects on the take-up of modern family planning. Conclusion Demand for pregnancy tests is high and access to pregnancy tests has the potential to facilitate the demand for family planning. At the same time, more research is needed to understand underlying beliefs about pregnancy status and risk that guide behaviors ultimately important for maternal and neonatal health. Trial registration The study was pre-registered in July 2018 for AEA RCT registry (AEARCTR-0003187) and clinicaltrials.gov (NCT03975933). Registered 05 June 2019, https://clinicaltrials.gov/ct2/show/record/NCT03975933

scholarly journals Tailored message interventions versus typical messages for increasing participation in colorectal cancer screening among a non-adherent population: A randomized controlled trial

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Kei Hirai ◽  
Yoshiki Ishikawa ◽  
Jun Fukuyoshi ◽  
Akio Yonekura ◽  
Kazuhiro Harada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trial ◽  
Screening Program ◽  
Controlled Trial ◽  
Baseline Survey ◽  
Attendance Rates ◽  
Community Based ◽  
Crc Screening ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background The purpose of this study was to examine the effectiveness and cost-efficiency of a tailored message intervention compared with a non-tailored message intervention for increasing colorectal cancer (CRC) screening rates among a non-adherent population, in a community-based client reminder program. Methods After a baseline survey for psychological segmentation, 2140 eligible individuals were randomly assigned either to a group with a tailored matched-message condition (N = 356), a group with a non-tailored unmatched-message condition (N = 355), or to two control groups, one using a typical message with a professional design (N = 717) and one without a professional design (N = 712). The main outcome measure was attendance rates in a community-organized CRC screening program within five months of receiving a print reminder. Results There was a significant difference in fecal occult blood test (FOBT) attendance rates at follow-up assessments between the tailored matched-message condition (14.0 %) and the control (9.9 %; OR = 1.48, p = 0.026), while there was no significant difference between the unmatched-message condition (11.0 %) and the control (OR = 1.12, p = 0.558), and between the matched-message condition and the unmatched-message condition (OR = 1.32, p = 0.219). The cost of a one-person increase in FOBT screening was 3,740 JPY for the tailored matched-message condition, while it was 2,747 JPY for the control. Conclusions A tailored-message intervention for segmented individuals designed to increase CRC screening rates in a community-based client reminder program was significantly effective compared to a usual reminder, but not more effective than an unmatched message in a randomized controlled trial, and was not sufficiently effective to highlight its value from a cost perspective. Therefore, the tailored intervention including target segmentation needs to be improved for future implementation in a CRC screening program for a non-adherent population. Trial registration UMIN Clinical Trials Registry UMIN000004384. Date of Registration: March 2011.

scholarly journals The Effect of Improved Access to Family Planning on Postpartum Women: Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Mahesh Karra ◽  
David Canning
Keyword(s):  
Randomized Controlled Trial ◽  
Family Planning ◽  
Data Collection ◽  
Contraceptive Use ◽  
Controlled Trial ◽  
Well Being ◽  
Birth Spacing ◽  
Randomized Controlled ◽  
Causal Impact

BACKGROUND The World Health Organization recommends that a woman waits at least 24 months after a live birth before getting pregnant again; however, an estimated 25% of birth intervals in low-income countries do not meet this recommendation for adequate birth spacing, and the unmet need for postpartum family planning (PPFP) services is high. Few randomized controlled trials have assessed the causal impact of access to PPFP services, and even fewer evaluations have investigated how such interventions may affect postpartum contraceptive use, birth spacing, and measures of health and well-being. OBJECTIVE This protocol paper aims to describe a randomized controlled trial that is being conducted to identify the causal impact of an intervention to improve access to PPFP services on contraceptive use, pregnancy, and birth spacing in urban Malawi. The causal effect of the intervention will be determined by comparing outcomes for respondents who are randomly assigned to an intervention arm against outcomes for respondents who are randomly assigned to a control arm. METHODS Married women aged 18-35 years who were either pregnant or had recently given birth were randomly assigned to either the intervention arm or control arm. Women assigned to the intervention arm received a package of services over a 2-year intervention period. Services included a brochure and up to 6 home visits from trained family planning counselors; free transportation to a high-quality family planning clinic; and financial reimbursement for family planning services, consultations, and referrals for services. Two follow-up surveys were conducted 1 and 2 years after the baseline survey. RESULTS A total of 2143 women were randomly assigned to either the intervention arm (n=1026) or the control arm (n=1117). Data collection for the first follow-up survey began in August 2017 and was completed in February 2018. A total of 1773 women, or 82.73% of women who were eligible for follow-up, were successfully contacted and reinterviewed at the first follow-up. Data collection for the second follow-up survey began in August 2018 and was completed in February 2019. A total of 1669 women, or 77.88% of women who were eligible for follow-up, were successfully contacted and reinterviewed at the second follow-up. The analysis of the primary outcomes is ongoing and is expected to be completed in 2021. CONCLUSIONS The results of this trial seek to fill the current knowledge gaps in the effectiveness of family planning interventions on improving fertility and health outcomes. The findings also show that the benefits of improving access to family planning are likely to extend beyond the fertility and health domain by improving other measures of women’s well-being. CLINICALTRIAL American Economics Association Registry Trial Number AEARCTR-0000697; https://www.socialscienceregistry.org/trials/697 Registry for International Development Impact Evaluations (RIDIE) Trial Number RIDIE-STUDY-ID-556784ed86956; https://ridie.3ieimpact.org/index.php?r=search/detailView&id=320 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16697

scholarly journals A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial

Contraception ◽  
2016 ◽  
Vol 94 (1) ◽  
pp. 58-67 ◽  
Author(s):  
Elizabeth Miller ◽  
Daniel J. Tancredi ◽  
Michele R. Decker ◽  
Heather L. McCauley ◽  
Kelley A. Jones ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Family Planning ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Family Planning Clinic ◽  
Randomized Controlled ◽  
Reproductive Coercion ◽  
Cluster Randomized

scholarly journals A Randomized Controlled Trial on the Usefulness of Mobile Text Phone Messages to Improve the Quality of Care of HIV and AIDS Patients in Cameroon

2016 ◽  
Vol 10 (1) ◽  
pp. 93-103 ◽  
Author(s):  
Dickson Shey Nsagha ◽  
Innocent Lange ◽  
Peter Nde Fon ◽  
Jules Clement Nguedia Assob ◽  
Elvis Asangbeng Tanue
Keyword(s):  
Randomized Controlled Trial ◽  
Health Care Services ◽  
Controlled Trial ◽  
Intervention Group ◽  
Hiv And Aids ◽  
Baseline Survey ◽  
Control Group ◽  
People Living With Hiv ◽  
Randomized Controlled ◽  
Before And After

Background:HIV and AIDS are major public health problems in the world and Africa. In Cameroon, the HIV prevalence is 5.1%. Cellphones have been found to be useful in the provision of modern health care services using short message services (SMS). This study assessed the effectiveness of SMS in improving the adherence of people living with HIV and AIDS to their treatment and care in Cameroon.Methods:This intervention study used a randomized controlled trial design. Ninety participants seeking treatment at the Nkwen Baptist Health Center were recruited between August and September 2011 using a purposive sampling method. They were randomly allocated into the intervention and control groups, each containing 45 participants. In the intervention group, each participant received four SMSs per week at equal intervals for four weeks. The patients were investigated for adherence to ARVs by evaluating the number of times treatment and medication refill appointments were missed. Data were collected using an interviewer-administered questionnaire before and after intervention and analysed on STATA.Results:The baseline survey indicated that there were 55(61.1%) females and 35(38.9%) males aged 23 - 62 years; the mean age was 38.77 ± 1.08. Most participants were teachers [12 (13.3%)], farmers [11 (12.2%)], and businessmen [24 (26.7%)]. Adherence to ARVs was 64.4% in the intervention group and 44.2% in the control group (p= 0.05). 2(4.4%) patients in the control group failed to respect their drug refill appointments while all the 45(100%) participants in the intervention group respected their drug refill appointments. 54.17% of married people and 42.9% of the participants with primary and secondary levels of education missed their treatment. Key reasons for missing treatment were late home coming (54%), forgetfulness (22.5%), and travelling out of station without medication (17.5%). Other factors responsible for non-adherence included involvement in outdoor business (60.87%), ARV stock out (37.8%), and not belonging to a support group (10.23%). Twenty eight (62.22%) subjects in the intervention group were able to take their treatment regularly and on time.Conclusion:SMS improved adherence to ARVs. Key constraints which affect adhere to ARV medication can be addressed using SMS.

scholarly journals The Effect of Improved Access to Family Planning on Postpartum Women: Protocol for a Randomized Controlled Trial

10.2196/16697 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e16697
Author(s):  
Mahesh Karra ◽  
David Canning
Keyword(s):  
Randomized Controlled Trial ◽  
Family Planning ◽  
Data Collection ◽  
Contraceptive Use ◽  
Controlled Trial ◽  
Well Being ◽  
Birth Spacing ◽  
Randomized Controlled ◽  
Causal Impact

Background The World Health Organization recommends that a woman waits at least 24 months after a live birth before getting pregnant again; however, an estimated 25% of birth intervals in low-income countries do not meet this recommendation for adequate birth spacing, and the unmet need for postpartum family planning (PPFP) services is high. Few randomized controlled trials have assessed the causal impact of access to PPFP services, and even fewer evaluations have investigated how such interventions may affect postpartum contraceptive use, birth spacing, and measures of health and well-being. Objective This protocol paper aims to describe a randomized controlled trial that is being conducted to identify the causal impact of an intervention to improve access to PPFP services on contraceptive use, pregnancy, and birth spacing in urban Malawi. The causal effect of the intervention will be determined by comparing outcomes for respondents who are randomly assigned to an intervention arm against outcomes for respondents who are randomly assigned to a control arm. Methods Married women aged 18-35 years who were either pregnant or had recently given birth were randomly assigned to either the intervention arm or control arm. Women assigned to the intervention arm received a package of services over a 2-year intervention period. Services included a brochure and up to 6 home visits from trained family planning counselors; free transportation to a high-quality family planning clinic; and financial reimbursement for family planning services, consultations, and referrals for services. Two follow-up surveys were conducted 1 and 2 years after the baseline survey. Results A total of 2143 women were randomly assigned to either the intervention arm (n=1026) or the control arm (n=1117). Data collection for the first follow-up survey began in August 2017 and was completed in February 2018. A total of 1773 women, or 82.73% of women who were eligible for follow-up, were successfully contacted and reinterviewed at the first follow-up. Data collection for the second follow-up survey began in August 2018 and was completed in February 2019. A total of 1669 women, or 77.88% of women who were eligible for follow-up, were successfully contacted and reinterviewed at the second follow-up. The analysis of the primary outcomes is ongoing and is expected to be completed in 2021. Conclusions The results of this trial seek to fill the current knowledge gaps in the effectiveness of family planning interventions on improving fertility and health outcomes. The findings also show that the benefits of improving access to family planning are likely to extend beyond the fertility and health domain by improving other measures of women’s well-being. Trial Registration American Economics Association Registry Trial Number AEARCTR-0000697; https://www.socialscienceregistry.org/trials/697 Registry for International Development Impact Evaluations (RIDIE) Trial Number RIDIE-STUDY-ID-556784ed86956; https://ridie.3ieimpact.org/index.php?r=search/detailView&id=320 International Registered Report Identifier (IRRID) DERR1-10.2196/16697

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