Behavioural intervention for adolescent uptake of family planning: a randomized controlled trial, Uganda. 2021

Sara Flanagan, and Arielle Gorstein, and Martha Nicholson, and Stephanie Bradish, and Diana Amanyire, and Andrew Gidudu, and Francis Aucur, and Julius Twesigye, and Faith Kyateka, and Samuel Balamaga, and Alison Buttenheim, and Emily Zimmerman
ideas42, 80 Broad St 30Fl, New York, NY 10004, United States of America (USA).

OBJECTIVE To evaluate the impact of a peer-referral and clinic welcome programme for reducing barriers to adolescents' uptake of family planning services in Uganda. METHODS We developed an intervention using behavioural design and carried out a stratified, randomized controlled evaluation of the intervention in girls aged 15-19 years. Sexual and reproductive health clinics were randomized into control (56 clinics) and intervention groups (60 clinics). All intervention clinics received the core intervention (materials to create an adolescent-friendly environment and referral cards to give to friends), while a subset of clinics additionally received training in youth-friendly service provision. We collected clinics' routine data on monthly numbers of visits by adults and adolescents over a 15-month baseline and 6-month intervention period, 2018-2020. RESULTS In multivariate regression analysis we found significant effects of the intervention on primary outcomes in the pooled intervention group compared with control. Mean monthly visits by adolescents increased by 45% (incidence rate ratio, IRR: 1.45; 95% confidence interval, CI: 1.14-1.85), or over five additional adolescent clients per clinic per month. The mean adolescent proportion of total clients improved by 5.3 percentage points (95% CI: 0.02-0.09). Within treatment arms, clinics receiving the training in youth-friendly service provision showed the strongest effects: a 62% increase (IRR: 1.62; 95% CI: 1.21-2.17) in adolescent clients, or over seven additional adolescents per clinic per month, relative to the control group. CONCLUSIONS A behavioural change intervention designed to target identified barriers can increase adolescents' uptake of family planning counselling and services.

UI MeSH Term Description Entries
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D005193 Family Planning Services Health care programs or services designed to assist individuals in the planning of family size. Various methods of CONTRACEPTION can be used to control the number and timing of childbirths. Family Planning,Family Planning Programs,Planned Pregnancy,Pregnancy, Planned,Family Planning Program,Family Planning Service,Planned Pregnancies,Planning Service, Family,Planning Services, Family,Pregnancies, Planned,Program, Family Planning,Programs, Family Planning,Service, Family Planning,Services, Family Planning
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000554 Ambulatory Care Facilities Those facilities which administer health services to individuals who do not require hospitalization or institutionalization. Clinics, Free-Standing,Health Centers, Ambulatory,Outpatient Clinics,Abortion Centers,Abortion Clinics,Ambulatory Care Facilities, Non Hospital,Ambulatory Care Facilities, Non-Hospital,Ambulatory Care Facilities, Nonhospital,Clinic Activities,Family Planning Centers,Outpatient Clinic,Urgent Care Centers,Urgent Care Clinics,Abortion Center,Abortion Clinic,Activities, Clinic,Activity, Clinic,Ambulatory Care Facility,Ambulatory Health Center,Ambulatory Health Centers,Care Center, Urgent,Care Centers, Urgent,Care Clinic, Urgent,Care Clinics, Urgent,Center, Abortion,Center, Ambulatory Health,Center, Family Planning,Center, Urgent Care,Centers, Abortion,Centers, Ambulatory Health,Centers, Family Planning,Centers, Urgent Care,Clinic Activity,Clinic, Abortion,Clinic, Free-Standing,Clinic, Outpatient,Clinic, Urgent Care,Clinics, Abortion,Clinics, Free Standing,Clinics, Outpatient,Clinics, Urgent Care,Facilities, Ambulatory Care,Facility, Ambulatory Care,Family Planning Center,Free-Standing Clinic,Free-Standing Clinics,Health Center, Ambulatory,Urgent Care Center,Urgent Care Clinic
D012736 Sex Education Education which increases the knowledge of the functional, structural, and behavioral aspects of human reproduction. Education, Sex,Sexuality Education,Education, Family Planning,Family Planning Education,Family Planning Instructors,Family Planning Training,Education, Sexuality,Family Planning Instructor,Instructor, Family Planning,Instructors, Family Planning,Training, Family Planning
D014454 Uganda A republic in eastern Africa, south of SUDAN and west of KENYA. Its capital is Kampala. Republic of Uganda

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