Communicating contraceptive effectiveness: A randomized controlled trial to inform a World Health Organization family planning handbook

Objective The objective of the study was to compare 3 different approaches for increasing clientsʹ understanding of contraceptive effectiveness. Study design We randomized 900 reproductive-age women in India and Jamaica to 1 of 3 charts presenting pregnancy risk. Results The most important reason for choosing a contraceptive was how well it prevents pregnancy (54%) followed by few side effects (17%). At baseline, knowledge about contraceptive effectiveness was poor. About half knew oral contraceptive pills are more effective than condoms (46%) and intrauterine devices are more effective than injectables (50%). All 3 charts improved knowledge significantly (P< .01) for these 2 questions. No chart improved knowledge better than any other (P> .05). The chart ranking contraceptive methods on a continuum was judged slightly easier to understand than the other 2 charts. Conclusion Only with accurate understanding of pregnancy risk can clients make informed choices. Our results have already informed a global handbook for family planning providers to use the chart ranking contraceptive methods on a continuum.