Elia Díez1,2,3,4,5, Maria J López1,3,4,5, Marc Marí-Dell'Olmo1,3,4,5, Laia Nebot6, Gloria Pérez1,3,4,5, Joan R Villalbi1,3,4,5, Ramon Carreras2,6. 1. Agència de Salut Pública de Barcelona. Plaça Lesseps 1. 08023 Barcelona, Spain. 2. Universitat Autònoma de Barcelona. Campus de la UAB, Plaça Cívica s/n. 08193 Bellaterra, Spain. 3. CIBER de Epidemiología y Salud Pública (CIBERESP). Centro de Investigación Biomédica en Red. Instituto de Salud Carlos III. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain. 4. Universitat Pompeu Fabra. Plaça de la Mercè 10-12. 08002 Barcelona, Spain. 5. Institut d'Investigació Biomèdica Sant Pau. Sant Antoni Maria Claret 167. 08025 Barcelona, Spain. 6. Hospital del Mar. Passeig Marítim 25-29. 08003 Barcelona, Spain.
Abstract
Background: This study aims to evaluate the effects of a community-based counselling intervention to improve contraception use among immigrant and native residents in deprived neighbourhoods. Methods: Randomized controlled trial. Women aged 14-49 years and men aged 14-39 years from two low-income neighbourhoods with high proportion of immigration in Barcelona (Catalonia, Spain) who had not undergone irreversible contraception and were not planning a pregnancy were recruited (2011-13). A culturally developed and theoretically based brief counselling intervention was delivered in community settings. The primary outcome was the consistent use of effective contraceptive methods (optimal use). Secondary outcomes were the incorrect use of effective methods and the use of less effective methods stratified by sex and migrant status. Differences within subgroups from baseline to the 3-month follow-up were analysed by intention to treat and per protocol. The effects were assessed with adjusted robust Poisson regressions. Results: The study enrolled and randomized 746 eligible participants. There were no differences between the intervention and control groups in demographic characteristics. Optimal use significantly increased in men, women, immigrants and natives in the intervention group, with no changes in the control group. In the intervention group, inconsistent use of effective methods decreased by 54.9% and that of less effective methods by 47.2%. The overall adjusted prevalence ratio of optimal use in the intervention group versus the control group was 1.138 (95% CI: 1.010-1.284). Conclusion: This brief counselling intervention increased the consistent use of effective contraception in low-income neighbourhoods with a high proportion of immigration.
RCT Entities:
Background: This study aims to evaluate the effects of a community-based counselling intervention to improve contraception use among immigrant and native residents in deprived neighbourhoods. Methods: Randomized controlled trial. Women aged 14-49 years and men aged 14-39 years from two low-income neighbourhoods with high proportion of immigration in Barcelona (Catalonia, Spain) who had not undergone irreversible contraception and were not planning a pregnancy were recruited (2011-13). A culturally developed and theoretically based brief counselling intervention was delivered in community settings. The primary outcome was the consistent use of effective contraceptive methods (optimal use). Secondary outcomes were the incorrect use of effective methods and the use of less effective methods stratified by sex and migrant status. Differences within subgroups from baseline to the 3-month follow-up were analysed by intention to treat and per protocol. The effects were assessed with adjusted robust Poisson regressions. Results: The study enrolled and randomized 746 eligible participants. There were no differences between the intervention and control groups in demographic characteristics. Optimal use significantly increased in men, women, immigrants and natives in the intervention group, with no changes in the control group. In the intervention group, inconsistent use of effective methods decreased by 54.9% and that of less effective methods by 47.2%. The overall adjusted prevalence ratio of optimal use in the intervention group versus the control group was 1.138 (95% CI: 1.010-1.284). Conclusion: This brief counselling intervention increased the consistent use of effective contraception in low-income neighbourhoods with a high proportion of immigration.
Authors: Elia Diez; Maria J Lopez; Gloria Perez; Irene Garcia-Subirats; Laia Nebot; Ramon Carreras; Joan R Villalbi Journal: BMC Public Health Date: 2020-01-08 Impact factor: 3.295