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. 2015 Aug;49(2 Suppl 1):S31-45.
doi: 10.1016/j.amepre.2015.03.023.

Impact of Contraceptive Counseling in Clinical Settings: A Systematic Review

Lauren B Zapata  1 , Stephen J Tregear  2 , Kathryn M Curtis  3 , Marie Tiller  2 , Karen Pazol  3 , Nancy Mautone-Smith  4 , Loretta E Gavin  4
Affiliations

Impact of Contraceptive Counseling in Clinical Settings: A Systematic Review

Lauren B Zapata et al. Am J Prev Med. 2015 Aug.

Abstract

Context: This systematic review evaluated the evidence on the impact of contraceptive counseling provided in clinical settings on reproductive health outcomes to provide information to guide national recommendations on quality family planning services.

Evidence acquisition: Multiple databases were searched during 2010-2011 for peer-reviewed articles published in English from January 1985 through February 2011 describing studies that evaluated contraceptive counseling interventions in clinical settings. Studies were excluded if they focused primarily on prevention of HIV or sexually transmitted infections, focused solely on men, or were conducted outside the U.S., Canada, Europe, Australia, or New Zealand.

Evidence synthesis: The initial search identified 12,327 articles, of which 22 studies (from 23 articles) met the inclusion criteria. Six studies examined the impact of contraceptive counseling among adolescents, with four finding a significant positive impact on at least one outcome of interest. Sixteen studies examined the impact of counseling among adults or mixed populations (adults and adolescents), with 11 finding a significant positive impact on at least one outcome of interest.

Conclusions: Promising components of contraceptive counseling were identified despite the diversity of interventions and inability to compare the relative effectiveness of one approach versus another. The evidence base would be strengthened by improved documentation of counseling procedures; assessment of intervention implementation and fidelity to put study findings into context; and development and inclusion of more RCTs, studies conducted among general samples of women, and studies with sample sizes sufficient to detect important behavioral outcomes at least 12 months post-intervention.

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Figures

Figure 1
Figure 1
Analytic framework for systematic review on the impact of contraceptive counseling in clinical settings. Note: Numbered lines map to key questions (Q). Dashed lines show logical relationships between outcomes, but these relationships were not assessed in this systematic review.
See this image and copyright information in PMC

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