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A family planning clinic based intervention: effects of provider-delivered education and counseling for intimate partner violence and reproductive coercion on contraceptive behaviors in women

Landowski, Allison (2018) A family planning clinic based intervention: effects of provider-delivered education and counseling for intimate partner violence and reproductive coercion on contraceptive behaviors in women. Master Essay, University of Pittsburgh.

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Abstract

Introduction: Intimate Partner Violence (IPV) is a public health issue that affects millions of Americans each year. As IPV victims have an increased risk for unintended pregnancy, strategies to promote contraception provision and utilization in this population is important. The randomized controlled trial intervention “Addressing Reproductive Coercion in Healthcare Settings (ARCHES)” provides education and screening of IPV, harm-reduction counseling, and referrals to services in healthcare settings. The purpose of this analysis is to determine the effects of ARCHES on contraceptive behaviors.
Methods: Data from 3683 women aged 18-29 years from a parallel-group cluster randomized controlled trial in 25 family planning clinics (17 clusters) in Western Pennsylvania were analyzed. Women were surveyed at baseline, 4 months, and 12 months after the intervention. Women pregnant at baseline or not recently sexually active were excluded. Generalized linear mixed models were used to determine the impact of the intervention on recent changes in any contraceptive use, use of any female-controlled contraceptive, self-efficacy of condom use score, and no contraceptive use. Covariates included age, race/ethnicity, education, nativity, relationship status, pregnancy history, pregnancy intention, and pregnancy status at 12-month follow-up.
Results: Most participants were younger than 24 years of age (73.1%), white (80.9%), had at least some college education (54.5%), and reported a history of recent contraceptive use (73.8%). In both groups, female-controlled contraceptive use increased between randomization and the end of follow-up. Women in the intervention exhibited a smaller improvement as compared to the control group (AOR:0.723, 95%CI:0.555,0.941). There were no other significant differences between the intervention and control groups from baseline to follow-up timepoints.
Discussion: There were not significant changes in contraceptive behaviors in the intervention arm compared to the control arm. Future studies should focus on contraceptive use as a harm-reduction strategy for unintended pregnancy in victims of IPV on a more diverse population. This is the first study to comprehensively examine the effects of a clinic-based IPV intervention on changes in different contraceptive behaviors to prevent unintended pregnancy.
Public Health Relevance: Clinic-based interventions like ARCHES can aid in improving contraceptive behaviors in victims of IPV/RC and reduce unintended pregnancy in high-risk populations.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Landowski, Allisonall168@pitt.eduall168
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairHaggerty, CatherineHaggertyC@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberMiller, Elizabethelizabeth.miller@chp.eduUNSPECIFIEDUNSPECIFIED
Committee MemberJones, Kelleykaj25@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 12 December 2018
Date Type: Submission
Number of Pages: 50
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 28 Sep 2019 20:04
Last Modified: 28 Sep 2019 20:04
URI: http://d-scholarship.pitt.edu/id/eprint/35762

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