Results Summary

What was the research about?

In the United States, 45 percent of pregnancies aren’t planned. A reproductive life plan based on a woman’s goals, resources, and values may help her decide whether, when, and how to have children.

In this study, the research team wanted to learn if a website on reproductive life planning helped women to choose and use birth control. The team also wanted to know if the website worked better when used with an action plan. In action planning, a woman makes plans for dealing with barriers to using birth control, such as how to remember to take a pill every day.

What were the results?

The research team didn’t find differences in birth control use among women who used reproductive life planning, reproductive life planning plus action planning, or only received information on birth control. Use of birth control increased for all groups during the study. Use of long-acting, reversible contraceptives, such as hormonal implants and intrauterine devices, or IUDs, also increased in all groups.

Who was in the study?

The study included 984 women who had health insurance with a company in Pennsylvania. Most of the women were white (94 percent), had graduated from college (93 percent), and had no children (68 percent). In addition, 45 percent of women were ages 18 to 25, 37 percent were ages 26 to 33, and 18 percent were ages 34 to 40. None of the women were planning to get pregnant in the next year. At the start of the study, 88 percent of women were using some form of birth control, and 12 percent reported using no birth control.

What did the research team do?

At the start of the study, all women in the study took a survey. The team then assigned the women to one of three groups by chance. The first group viewed an interactive website on reproductive life planning. Information on the site came from the U.S. Centers for Disease Control and Prevention. The information helped women decide if they wanted to become pregnant based on their current life goals. The website also gave women information on pregnancy and the birth control options that met their needs. The second group viewed the same website and completed an action plan for their current form of birth control. The third group viewed a website with standard information on common forms of birth control. All groups completed follow-up surveys and revisited their website every six months during the two-year study.

What were the limits of the study?

Most women in the study were white and well-educated. Also, all women had private health insurance and were from only one state. The findings may have been different with women from other backgrounds. At the start of the study, most women already used birth control and were satisfied with their choices. They may have already known about their birth control options.

Future studies could include women from different backgrounds. Future research could also focus on women who don’t always use birth control or on women who want to change their birth control method.

How can people use the results?

Researchers can use the results from this study to learn more about reproductive life planning and action planning programs.

Final Research Report

View this project's final research report.

More About This Research

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. Those comments and responses included the following:

  • Most reviewer comments requested that researchers provide additional details in the draft report, and the researchers did.
  • Reviewers questioned the need for this study’s intervention given that there was already a high rate of contraception use in the target population. The researchers noted that while overall use was high, over 40 percent of women do not use the most effective contraceptive methods, which this study hoped to change.
  • Reviewers asked whether the researchers considered including a true control comparison group that received no intervention. The researchers responded that they chose to provide the control group participants with basic birth control information as it’s widely available. The investigators also provided this information because they thought their study would be more useful by testing the added effect of reproductive life planning over and above this basic information.  
  • Reviewers asked about the addition of the method congruence outcome, which did not seem patient centered. The researchers responded that this outcome was actually patient centered. The investigators explained that they added the outcome in response to the patient advisory group’s suggestion to address situations in which a woman chose a birth control method that may not be most effective but would be most congruent with her own beliefs and expectations.
  • The reviewers identified a potential problem with the contraceptive satisfaction variable. The reviewers found that someone completing the survey once counted equal to someone who completed the survey multiple times, even though the latter provided more data. The researchers acknowledged that while this could be a problem for respondents who completed the survey during only one survey period, the high response rate at each survey period mitigated that concern.

Conflict of Interest Disclosures

View the COI disclosure form.

Journal Citations

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. Those comments and responses included the following:

  • Most reviewer comments requested that researchers provide additional details in the draft report, and the researchers did.
  • Reviewers questioned the need for this study’s intervention given that there was already a high rate of contraception use in the target population. The researchers noted that while overall use was high, over 40 percent of women do not use the most effective contraceptive methods, which this study hoped to change.
  • Reviewers asked whether the researchers considered including a true control comparison group that received no intervention. The researchers responded that they chose to provide the control group participants with basic birth control information as it’s widely available. The investigators also provided this information because they thought their study would be more useful by testing the added effect of reproductive life planning over and above this basic information.  
  • Reviewers asked about the addition of the method congruence outcome, which did not seem patient centered. The researchers responded that this outcome was actually patient centered. The investigators explained that they added the outcome in response to the patient advisory group’s suggestion to address situations in which a woman chose a birth control method that may not be most effective but would be most congruent with her own beliefs and expectations.
  • The reviewers identified a potential problem with the contraceptive satisfaction variable. The reviewers found that someone completing the survey once counted equal to someone who completed the survey multiple times, even though the latter provided more data. The researchers acknowledged that while this could be a problem for respondents who completed the survey during only one survey period, the high response rate at each survey period mitigated that concern.

Conflict of Interest Disclosures

Project Information

Cynthia Chuang, MD
Pennsylvania State University Hershey Medical Center
$1,815,080
10.25302/9.2019.CD.13046117

Key Dates

56 months
September 2013
August 2018
2013
2018

Study Registration Information

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Last updated: October 20, 2021