Using behavioral economic theory to increase use of effective contraceptives among opioid-maintained women at risk of unintended pregnancy

PREVENTIVE MEDICINE

卷:92

Article

Heil, Sarah H.^1,2,3  Hand, Dennis J.²  Sigmon, Stacey C.^1,2,3  Badger, Gary J.⁴  Meyer, Marjorie C.⁵  Higgins, Stephen T.^1,2,3 

[1] Univ Vermont, Vermont Ctr Behav & Hlth, Burlington, VT 05401 USA

[2] Univ Vermont, Dept Psychiat, Burlington, VT 05401 USA

[3] Univ Vermont, Dept Psychol, Burlington, VT 05401 USA

[4] Univ Vermont, Dept Med Biostat 4, Burlington, VT 05401 USA

[5] Univ Vermont, Dept Obstet Gynecol & Reprod Sci, Burlington, VT 05401 USA

关键词: Opioid substitution therapy;    Unintended pregnancy;    Contraceptives;    Birth control;    Long-acting reversible contraceptives (LARCs);    Behavioral economics;    Incentives;   

DOI  :  10.1016/j.ypmed.2016.06.023

来源: Elsevier

【 摘 要 】

Objective. An unsettling aspect of the US opioid epidemic is the high rate of in utero exposure, especially since most of these pregnancies are unintended, due in part to low rates of effective contraceptive use among opioid-using women. This study tested an intervention informed by behavioral economic theory and aimed at promoting effective contraceptive use among opioid-maintained women at risk of unintended pregnancy in the Burlington, VT, area between 2011 and 2013. Methods. Thirty-one women were assigned (initial 5 consecutively, subsequent 26 randomly) to either usual care or an experimental intervention. Participants in usual care received condoms, a dose of emergency contraception, and referral to local providers. Participants in the experimental condition received usual care plus the World Health Organization's contraception initiation protocol, including free prescription contraceptives, and financial incentives for attending 13 follow-up visits over 6 months to help manage side effects and other issues. Results. Significantly more women in the experimental vs. usual care control conditions initiated prescription contraceptive use (100% vs. 29%) and reported prescription contraceptive use at 1-month (63% vs. 13%), 3-month (88% vs. 20%), and 6-month (94% vs. 13%) assessments. None of the experimental condition participants became pregnant during the 6-month protocol vs. three women (20%) in the control condition. Conclusions. These results provide the first experimental evidence supporting the efficacy of an intervention for increasing prescription contraceptive use among opioid-maintained women at risk of unintended pregnancy. (C) 2016 Elsevier Inc. All rights reserved.

【 授权许可】

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