Peer counselling for the promotion of long-acting, reversible contraception among teens: a randomised, controlled trial

Abstract

Aim: To evaluate the impact peer counselling has on same-day desire for long-acting, reversible contraception (LARC) among adolescents attending a family planning clinic.

Methods: A randomised, controlled trial of 110 adolescent females attending an outpatient clinic for contraception in 2013. Adolescents received either brief peer counselling about LARC with routine contraceptive counselling, or routine counselling alone. Bivariate analyses and multivariable logistic regression assessed the primary outcome of same-day desire for LARC and secondary outcomes of change in knowledge and attitudes regarding LARC.

Results: Peer counselling was well received and 70% reported that it was helpful in contraceptive decision-making. Peer counselling did not affect same-day desire for LARC, however, adolescents who received the intervention were more likely to report increased knowledge and positive change in attitudes towards LARC (adjusted odds ratios: 6.6 (95% confidence interval: 2.0–22.0 and 6.4 (1.6–26.8), respectively). Factors positively associated with same-day LARC desire included greater reported peer contraceptive influence, peer use of LARC and social support. Twenty of the 36 adolescents who desired LARC at the end of their clinic visit did not receive one most commonly due to a need to schedule a specific appointment for the procedure and the need to return during a menstrual period for intrauterine device placement.

Conclusion: While brief, point-of-care peer counselling is well received, and can increase adolescent knowledge and positive attitude about our most effective contraceptive methods, barriers to same-day LARC placement limit immediate use.

Chinese abstract

目的: 为了评价同辈咨询对于去家庭规划门诊的青少年寻求长效, 可逆避孕方法（LARC）的影响。方法: 2013年, 门诊寻求避孕方法的110名成年女性的一项随机, 对照研究。青少年接受简短的LARC和常规避孕咨询或仅常规避孕咨询。协变量分析和多因素Logistic回归进行评估, 首要结果是LARC的当日需求, 次要结果是对LARC态度和认知的变化。结果: 同辈咨询被很好地接受, 并且70%的报告认为有助于避孕决策。同辈咨询并不影响LARC的当日（前）需求。但是, 接受干预的青少年可能会对LARC更加了解, 并持有积极的态度（调整后比值比分别是: 6.6（95%置信区间: 2.0-22.0和6.4（1.6-26.8））。LARC当前需求的正相关因素包括更多同伴避孕报道的影响, 同伴使用LARC和社会支持。36名中的20名青少年在门诊结束后想要LARC而没有使用主要是由于程序需要安排特定的预约以及需要在月经间期重返以放置宫内节育器。结论: 同辈咨询虽然短暂, 但是却可以被很好的接受, 并且能够提高青少年的认知, 增加对我们最有效避孕方法积极态度, 减少直接使用当前LARC的障碍。

Keywords:

• Adolescent health
• health behaviour
• reproductive health
• contraception
• health promotion
• patient education

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

This research was supported by the Society of Family Planning.