Effectiveness of contraceptive decision aids in adolescents and young adults: A Systematic Review.

Abstract

IMPORTANCE\nContraceptive decision aids may support adolescents and young adults (AYA) in choosing contraceptive methods that fit their unique reproductive health needs.\n\n\nOBJECTIVE\nTo provide a systematic review of studies examining the effectiveness of contraceptive decision aids in AYA.\n\n\nEVIDENCE REVIEW\nA systematic search was conducted of studies published between January 1, 2011 and March 31, 2021 using PubMed, Cochrane, and ClinicalTrials.gov. Studies were included if a contraceptive decision aid (i.e., paper handout, mobile application, website, or video) was evaluated in AYA populations (age ≤30 years old) in the United States. The primary outcome was decision aid effectiveness (i.e., change in contraceptive knowledge, interest in contraception, contraceptive use, unintended pregnancies, and satisfaction with the decision aid).\n\n\nFINDINGS\n7 randomized controlled trials and 3 pre/post studies, reporting on 3,725 AYA (range: 11-30 years), met inclusion criteria. No studies were excluded due to risk of bias. The methodologies and results were heterogeneous, but most consistently demonstrated increased contraceptive knowledge.\n\n\nCONCLUSIONS AND RELEVANCE\nTen studies evaluated a range of contraceptive decision aid formats for AYA. Decision aids appear effective at increasing contraceptive knowledge temporarily, but their effect on other contraceptive outcomes is unclear. Future research should evaluate decision aids specifically in adolescents.