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Unwanted pregnancy and contraceptive knowledge: identifying vulnerable groups from a randomized controlled trial of educational interventions

Unwanted pregnancy and contraceptive knowledge: identifying vulnerable groups from a randomized controlled trial of educational interventions
Unwanted pregnancy and contraceptive knowledge: identifying vulnerable groups from a randomized controlled trial of educational interventions
Objectives: the aim of this study was to identify predictors of contraceptive pill knowledge and their relationship to educational interventions.

Methods: a total of 636 women attending for a follow-up appointment for repeat prescription of the combined oral contraceptive pill with a GP or practice nurse were randomized to receive leaflets (simple summary leaflet or FPA leaflet), advice or neither. Sociodemographic details and contraceptive knowledge were determined using a validated contraceptive knowledge questionnaire sent after 3 months by post. The main outcomes were sociodemographic, contraceptive, attitudinal and educational predictors of knowledge.

Results: a total of 522 (82%) had complete questionnaires. After controlling for educational intervention and other confounding variables, independent predictors of knowledge were further education (adjusted odds ratio 2.98, 95% confidence interval 1.78–4.99); number of years on the pill (0–5, 6–10, >10 years) 1.0, 0.56 (0.33–0.95) and 0.34 (0.19–0.59), respectively; past emergency contraception (1.87, 1.18–2.97); and importance attached to not falling pregnant (1.83, 1.02–3.29). These predictors are less powerful than the impact of most educational interventions (range of odds ratios for interventions: 1.85–6.81), and there was no evidence of a separate effect of educational intervention in any subgroup, except that leaflets have a larger effect in women who have needed emergency contraception in the past (no past use or simple summary and FPA leaflets, 1.74 and 0.90, respectively; with past use, 3.47 and 3.83; interaction term chi-square 6.92, P = 0.03).

Conclusion: educational interventions are as important as sociodemographic features in determining knowledge. With limited time for full educational interventions in practice, priorities for intervention should be women who have used emergency contraception in the past—who will benefit most—and those on the pill for >5 years or with no further education who are at highest risk due to poor knowledge.
contraception, education, knowledge, leaflet
0263-2136
449-453
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Griffin, Simon
82ce3f76-cd32-4125-8b46-0cae8f1e2278
Dickson, Nigel
20949637-60f2-4235-a9d9-12676b38212b
Sadler, Carolyn
334206ef-a2cd-48e2-b102-5761c96d2c26
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Griffin, Simon
82ce3f76-cd32-4125-8b46-0cae8f1e2278
Dickson, Nigel
20949637-60f2-4235-a9d9-12676b38212b
Sadler, Carolyn
334206ef-a2cd-48e2-b102-5761c96d2c26

Little, Paul, Griffin, Simon, Dickson, Nigel and Sadler, Carolyn (2001) Unwanted pregnancy and contraceptive knowledge: identifying vulnerable groups from a randomized controlled trial of educational interventions. Family Practice, 18 (4), 449-453.

Record type: Article

Abstract

Objectives: the aim of this study was to identify predictors of contraceptive pill knowledge and their relationship to educational interventions.

Methods: a total of 636 women attending for a follow-up appointment for repeat prescription of the combined oral contraceptive pill with a GP or practice nurse were randomized to receive leaflets (simple summary leaflet or FPA leaflet), advice or neither. Sociodemographic details and contraceptive knowledge were determined using a validated contraceptive knowledge questionnaire sent after 3 months by post. The main outcomes were sociodemographic, contraceptive, attitudinal and educational predictors of knowledge.

Results: a total of 522 (82%) had complete questionnaires. After controlling for educational intervention and other confounding variables, independent predictors of knowledge were further education (adjusted odds ratio 2.98, 95% confidence interval 1.78–4.99); number of years on the pill (0–5, 6–10, >10 years) 1.0, 0.56 (0.33–0.95) and 0.34 (0.19–0.59), respectively; past emergency contraception (1.87, 1.18–2.97); and importance attached to not falling pregnant (1.83, 1.02–3.29). These predictors are less powerful than the impact of most educational interventions (range of odds ratios for interventions: 1.85–6.81), and there was no evidence of a separate effect of educational intervention in any subgroup, except that leaflets have a larger effect in women who have needed emergency contraception in the past (no past use or simple summary and FPA leaflets, 1.74 and 0.90, respectively; with past use, 3.47 and 3.83; interaction term chi-square 6.92, P = 0.03).

Conclusion: educational interventions are as important as sociodemographic features in determining knowledge. With limited time for full educational interventions in practice, priorities for intervention should be women who have used emergency contraception in the past—who will benefit most—and those on the pill for >5 years or with no further education who are at highest risk due to poor knowledge.

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More information

Published date: 18 August 2001
Keywords: contraception, education, knowledge, leaflet

Identifiers

Local EPrints ID: 24390
URI: http://eprints.soton.ac.uk/id/eprint/24390
ISSN: 0263-2136
PURE UUID: 6e53f964-c5d9-491d-9bee-81f4ebce2c25

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Date deposited: 30 Mar 2006
Last modified: 08 Jan 2022 06:48

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Contributors

Author: Paul Little
Author: Simon Griffin
Author: Nigel Dickson
Author: Carolyn Sadler

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