: The purpose of our study is to determine whether an innovative way of providing contraception, in the home, could reduce the incidence of unintended pregnancy for low income and minority women who have already had one birth. Women with a first-borne infant found to be at high risk for medical and social problems through a community-based screening program who are interested in delaying a subsequent pregnancy will be randomized into two groups. The first group will receive a home visit by a community health nurse, who will provide contraceptive counseling, including a referral to publicly funded family planning clinic. The second group will receive the same services, but will also receive either a three-month supply of oral contraceptives or a depo-medroxyprogesterone injection. The study has two objectives: to determine whether this practice reduces subsequent unintended pregnancies in this population and whether this practice encourages or discourages utilization of clinic-based preventive services, such as sexually transmitted disease and cervical cancer screening. The results of our study have important implications for public health. Most local public health departments throughout the United States already use community health nurses to deliver many services at home, including case management for families with infants at risk for medical and social problems. If delivery of contraceptives at home is effective in reducing subsequent unintended pregnancies for these families, local health departments across the country could add this service for very little added cost. To the extent that home contraceptive delivery model proves successful at widening the interval between births for low-income and minority women, and increases the likelihood that subsequent pregnancies are intended, it will increase the likelihood of having babies born healthier.
| Melnick, Alan L; Rdesinski, Rebecca E; Creach, E Dawn et al. (2008) The influence of nurse home visits, including provision of 3 months of contraceptives and contraceptive counseling, on perceived barriers to contraceptive use and contraceptive use self-efficacy. Womens Health Issues 18:471-81 |
| Rdesinski, Rebecca E; Melnick, Alan L; Creach, Elizabeth Dawn et al. (2008) The costs of recruitment and retention of women from community-based programs into a randomized controlled contraceptive study. J Health Care Poor Underserved 19:639-51 |
