Insured women benefiting from the Affordable Care Act (ACA)’s contraceptive coverage mandate may be well-positioned to respond to interventions designed to assist them in making personalized contraceptive choices, such as reproductive life planning and contraceptive action planning. Reproductive life planning is recommended by federal and clinical guidelines but has not been evaluated systematically for effectiveness.
In 2014, the MyNewOptions study randomized 984 privately insured women ages 18-40 and not intending pregnancy in the next year to web-based reproductive life planning (RLP); reproductive life planning with contraceptive action planning (RLP+); or information-only control. Any contraceptive use, prescription contraceptive use, method adherence, switching to a more effective method, method satisfaction, and contraceptive self-efficacy were assessed during the two-year follow-up period using binomial logistic regression, linear regression and GEE models.
Contraceptive use (94-95%) and high contraceptive adherence (72-76%) did not differ between the study groups during the two-year follow-up. Switching to a more effective method, method satisfaction, and contraceptive self-efficacy did not differ by group. Contraceptive use increased (from 89% at baseline to 96% at 2 years) and long-acting reversible contraceptive (LARC) use increased (from 8% at baseline to 19% at 2 years), but there were no differences by group allocation.
The MyNewOptions study does not provide evidence that web-based reproductive life planning changes contraceptive behaviors in insured women outside of the clinical setting. Further research is needed to identify strategies that effectively provide reproductive-age women with better access to woman-centered contraceptive methods that meet individual needs and preferences.