Silver School Study Aims to Improve Contraceptive Counseling in the United States

Roughly half of all pregnancies in the United States each year are unplanned, and about two-thirds of those pregnancies occur among women under the age of 30. Unmarried women in their twenties account for about one million unplanned pregnancies each year, or more than 2,700 every day. Women with unplanned pregnancies tend to receive prenatal care later, and their children are at greater risk of low birth weight and preterm birth, as well as slower cognitive development in early childhood.

Now James Jaccard, a psychologist and professor of social work, has been awarded a three-year, $750,000 grant from the Office of Population Affairs of the Department of Health and Human Services for a research project entitled "Improving Contraceptive Counseling in the U.S." to help reduce unintended pregnancies among young women.

For this project, Jaccard, who is associate dean for research at the Silver School of Social Work and co-director of the School's Center for Latino Adolescent and Family Health, is working with Planned Parenthood Federation of America and 10 clinics around the country.

The project is designed to develop new contraceptive counseling protocols that are grounded in scientific evidence on contraceptive behavior and decision science. The researchers will evaluate the protocol's usefulness in promoting behaviors by women that help prevent unintended pregnancy.

Ten family planning clinics funded under Title X of the Public Health Service Act will be randomly assigned to treatment as usual or implementation of the contraceptive counseling protocol. About 135 women will be selected for study participation in each clinic, yielding 1,350 clients in total (half control and half protocol).

Immediately after their counseling session ends, the participants will complete a computer-administered interview and then will be re-interviewed six and 12 months later to assess gaps in protection, their consistent and correct use of contraceptives, method switching, and unintended pregnancies. The effect of the counseling protocol on these outcomes will be determined.

The final three months of the study will prepare the protocol materials for widespread dissemination at clinics throughout the United States.