Theory-based strategies for improving contraceptive use: a systematic review☆
Received 7 November 2008; received in revised form 18 December 2008; accepted 19 December 2008. published online 09 February 2009.
Abstract
Background
Theories and models help explain how behavior change occurs. We systematically reviewed randomized controlled trials that examined theory-based interventions for improving contraceptive use.
Study Design
We searched electronic databases for eligible trials. Primary outcomes included pregnancy and contraceptive use. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data.
Results
Of 14 included trials, 10 showed positive results for a theory-based group: 2 of 10 studies with pregnancy or birth data, 4 of 9 addressing contraceptive use (for contraception) and 5 of 9 with condom use (to prevent HIV/sexually transmitted infections). An experimental group had favorable results for six of seven trials based on Social Cognitive Theory, two based on other social cognition models and two using motivational interviewing. Most interventions focused on adolescents and involved multiple sessions.
Conclusions
Effects were not consistent across outcomes and comparisons. The field could benefit from thorough use of single theories and better reporting on intervention implementation.
☆ Partial support for this study was provided by Family Health International (FHI) with funds from the U.S. Agency for International Development and the National Institute of Child Health and Human Development. The views expressed in this article do not necessarily reflect those of FHI or the agencies funding the project.
ABSTRACT