Computer assisted decision making on contraceptive use
ESC Congress Library. French R. May 20, 2010; 4508
Dr. Rebecca French
Dr. Rebecca French
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Computer assisted decision-making on contraceptive use

Dr Rebecca French, Senior Lecturer in Sexual and Reproductive Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT email: Rebecca.French@lshtm.ac.uk

With consistent and correct use, the majority of contraceptive methods are highly effective in preventing pregnancy. However, to date, strategies to improve adherence and acceptability of contraceptives have been disappointing. Inadequate understanding of the contraceptive decision-making process has been cited as one reason for the failure to develop effective interventions to reduce unplanned pregnancy as well as the spread of sexually transmitted infections (STIs). Further, the evidence is that the repertoire of methods from which choices are made is overly narrow.

Decision aids are increasingly used in the context of health care decision making. They may take a number of formats, including those that are computer-based, and adopt variety of approaches, from scenario planning to more formal decision analysis. They provide a structured framework within which options may be systematically analysed and selected taking account of their possible outcomes in relation to individual needs and values. Where standard health education provides information on which to base a decision, decision aids go further, identifying the risks and benefits and encouraging consideration of values associated with each. Benefits of decision aids include their interactivity and engagement of the user; they can easily tailor information to the user; and, when available via the internet, use can be self-paced and accessible for those who have difficulty assessing services. Decision aids may be particularly suitable tools to help people with contraceptive decision-making for a number of reasons. Most people are faced with decisions around fertility control and STI avoidance at some time in their life. For the individual, the repercussions of ‘poor’ contraceptive decisions can be long-lasting and can have negative social and health consequences. At a societal level, ‘poor’ contraception decisions have public health and cost implications.

This presentation describes the development of a web-based contraceptive decision aid, which used Multi-Criteria Decision Analysis, to help people with contraceptive choices.

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