Evaluation of two intervention models on contraceptive attitudes and behaviors among nulliparous women in Shanghai, China: a clustered randomized controlled trial

Integrating contraceptive services into existing perinatal care: protocol for a community-based cluster randomised controlled trial in Shanghai, China

INTRODUCTION

Postpartum contraception is essential to preventing unintended pregnancies and short interpregnancy intervals. The first year after childbirth is a critical period with a high risk of unintended pregnancy and induced abortion. However, the postpartum contraceptive services are weak in China's existing maternal and child healthcare system. We propose to evaluate the effects of integrating postpartum contraceptive services into the existing perinatal care system via a cluster randomised controlled trial.

METHODS AND ANALYSIS

This cluster randomised controlled trial involves all 13 communities of Minhang District, Shanghai, China. Communities will be randomly allocated, seven in the intervention group and six in the control group. One thousand and three hundred women, 100 women in each community, will be recruited in the study. Women assigned to the intervention group will receive postpartum contraceptive education and counselling during pregnancy, childbirth hospitalisation, postpartum home visits and the 42-day postpartum clinic check-up. Women in the control group will receive routine antenatal and postpartum care. Participants will be recruited in the first trimester during pregnancy and followed up to 1 year postpartum. The primary outcome is the incidence of unintended pregnancy within 1 year after childbirth.

ETHICS AND DISSEMINATION

The trial received ethical approval from the Ethics Committee of Shanghai Minhang District Maternal and Child Health Care Hospital (#[2020]KS-02, #[2020]KS-05, #[2020]KS-05-EX). Results will be published in academic journals and disseminated in multiple formats for the health professionals and the public.

TRIAL REGISTRATION NUMBER

ChiCTR2000034603.

Factors Associated with the Choice of Contraceptive Method following an Induced Abortion after Receiving PFPS Counseling among Women Aged 20-49 Years in Hunan Province, China

BACKGROUND

There is limited research on postabortion family planning (PAFP) services and subsequent contraception in China. The current study aimed to identify women's contraceptive methods choices and associated factors after receiving PAFP services.

METHODS

A cross-sectional study used a cluster, stratified and multistage random sample to collect data. All eligible data were analyzed using SPSS 26.0. The chi-square test was used to assess the association between categorical variables. Significant variables (p < 0.05) and all potential variables were then included in the binary logistic regression model for analysis.

RESULTS

Approximately 84.7% (1043/1231) of participants had received pre-abortion PAFP counselling, and approximately 90% of them chose reliable methods. Farmers or workers (OR = 0.297, 95% CI: 0.130-0.683), family monthly income (3000-4999 RMB, OR = 0.454, 95% CI: 0.212-0.973; ≥5000 RMB, OR = 0.455, 95% CI: 0.228-0.909), reliable advice from services providers before abortion (OR = 0.098, 95% CI: 0.039-0.250), painless surgical abortion (OR = 3.465, 95% CI 1.177-10.201), and postabortion follow-up (OR = 0.543, 95% CI: 0.323-0.914) and were associated with contraception choice after receiving PAFP services.

CONCLUSIONS

This study emphasizes the importance of pre-abortion PAFP counselling, postabortion follow-up, and increased focus on women who have experienced painless abortion. The study provides direction for PAFP services policymakers, as well as a reference for contraceptive counselling research around the world.

Effect of education on knowledge of fertility counseling and attitudes toward fertility control

BACKGROUND

The development of any society depends on proper planning in various fields such as population and birth control. Fertility control is designed to create a level of population growth appropriate to the resources available and to ensure a good life. Receiving information and education is one of the basic strategies to change the attitude toward fertility and awareness in most people in society. Therefore, this study was conducted to determine the effect of education on knowledge of fertility counseling and attitudes toward fertility control in health workers.

MATERIALS AND METHODS

The present study was a randomized clinical trial with a control group that was conducted in the presence of 107 health workers of health centers and community health centers working in Mashhad in 2017. The research units were randomly divided into three groups (webinar training, group discussion training, and control). Research tools were researcher-made questionnaires on attitudes toward fertility and measuring healthy reproductive awareness that all study participants completed at the beginning of the study and 2 weeks after the intervention. Data analysis was performed by the Chi-square, one-way analysis of variance, and independent t-test using the SPSS software version 16.

RESULTS

The results of this study showed that at the beginning of the study, all three groups were homogeneous in terms of quantitative and qualitative demographic variables including age, education, work experience, type of employment, and number of family members. The results of Kruskal-Wallis test showed that before the intervention, the three groups did not have a statistically significant difference in terms of mean scores of awareness about fertility counseling (P = 0.77) and attitude toward fertility control (P = 0.523), but this relationship was significant after the interventions. Furthermore, the results of Mann-Whitney intragroup test showed that the scores before and after the intervention were significant in both educational groups (P = 0.001).

CONCLUSION

Considering the importance of healthy fertility counseling and the important place of education in promoting awareness and attitude toward healthy fertility, it is recommended to use active educational methods to promote the awareness and attitude of health workers to provide healthy fertility services to couples.

Effect of Health Lecture using Media and Peer-Education on Long Acting and Permanent Methods of Contraception

Introduction: Long-acting and permanent methods of contraception (LAPMs) are known as highly-effective contraception. The Department of Health of East Java Province stated that LAPM participation is still below target. One of the factors is the Interpersonal Communication (IPC) skill of the Health Practitioners. This study aimed to identify the influence of health lectures using media and peer-education on the knowledge and attitude of pregnant women regarding LAPMs. Peer-education is the novelty of this study.Methods: A two-group quasi experimental design was applied with all of the pregnant women at Kesugihan Public Health Center (PHC) as the treatment group. They were given lectures with media inclusion (contraception booklets and visual aids) and peer-education during a pregnancy class. Pregnant women at Ngebel PHC were the control group. One woman who had experience with LAMPs was trained as a peer-educator. Thirty participants in each group were chosen using the total sampling technique. The data collected was analyzed using univariate and bivariate analyses by applying the Wilcoxon Signed-Rank and Mann-Whitney tests.Results: The participants showed an increased knowledge before and after the intervention in the treatment group (83%), while in control group, it was slightly increased (1%). Attitude differences were also found in both groups (treatment = 56.7%, control = 13.3%). The Mann-Whitney test resulted in significant differences on knowledge (p <0.001) and attitude (p = 0.016) between the two groups.Conclusion: The local department of health may optimize IPC using media and peer-education to improve the knowledge and attitude of pregnant women regarding LAPM participation.