***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The objective of the study was to compare 3 different approaches for increasing clients ' underst and ing of contraceptive effectiveness . STUDY DESIGN We r and omized 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 underst and than the other 2 charts . CONCLUSION Only with accurate underst and ing of pregnancy risk can clients make informed choices . Our results have already informed a global h and book for family planning providers to use the chart ranking contraceptive methods on a continuum Objectives To compare two post-abortion family planning ( FP ) service packages on contraceptive use and repeat abortion rate  among young women in three cities in China . Methods In this cluster-r and omized trial , one FP service package included provision of limited information and referral to existing FP services , and the other , more comprehensive , package consisted – in addition to the above simple package – of individual counselling , free provision of contraceptive material s , and involvement of the male partner . Eight matched pairs of hospitals were certified by central ized r and omization . Women undergoing abortion were followed up for six months , and data were collected in two rounds , before and after the intervention . Results We followed a total of 2336 women younger than 25 years ( 555 before and 555 after the simple intervention package ; 634 before and 592 after the comprehensive intervention package ) . Both packages increased use of any contraceptive method , but the comprehensive approach also increased use of more effective methods . Odds ratios for consistent and correct use of condoms were 2.32 ( 95 % confidence interval 1.55–3.46 ) and 2.78 ( 1.81–4.26 ) , respectively , compared with the simple package . The rates of unwanted pregnancies and repeat abortions were somewhat reduced for both packages , with no significant statistical difference between them . Conclusion Couples who received the comprehensive post-abortion FP service appear to use more effective contraceptive methods and show better compliance OBJECTIVE To introduce and promote the use of long-acting reversible methods of contraception ( LARC ; intrauterine contraceptives and subdermal implant ) by removing financial and knowledge barriers . STUDY DESIGN The Contraceptive CHOICE Project is a prospect i ve cohort study of 10,000 women 14 - 45 years who want to avoid pregnancy for at least 1 year and are initiating a new form of reversible contraception .  Women screened for this study are read a script regarding long-acting reversible methods of contraception to increase awareness of these options . Participants choose their contraceptive method that is provided at no cost . We report the contraceptive choice and baseline characteristics of the first 2500 women enrolled August 2007 through December 2008 . RESULTS Sixty-seven percent of women enrolled ( 95 % confidence interval , 65.3 - 69.0 ) chose  long-acting methods .  Fifty-six percent selected  intrauterine contraception  and 11 % selected the subdermal implant .  CONCLUSION Once financial barriers were removed and long-acting reversible methods of contraception were introduced to all potential participants as a first-line contraceptive option , two-thirds chose long-acting reversible methods of contraception Abstract Objective : To determine whether a theoretically based sex education programme for adolescents ( SHARE ) delivered by teachers reduced unsafe sexual intercourse compared with current practice . Design : Cluster r and omised trial with follow up two years after baseline ( six months after intervention ) . A process evaluation investigated the delivery of sex education and broader features of each school . Setting : Twenty five secondary schools in east Scotl and . Participants : 8430 pupils aged 13 - 15 years ; 7616 completed the baseline question naire and 5854 completed the two year follow up question naire . Intervention : SHARE programme ( intervention group ) versus existing sex education ( control programme ) . Main outcome measures : Self reported exposure to sexually transmitted disease , use of condoms and contraceptives at first and most recent sexual intercourse , and unwanted pregnancies . Results : When the intervention group was compared with the conventional sex education group in an intention to treat analysis there were no differences in sexual activity or sexual risk taking by the age of 16 years . However , those in the intervention group reported less regret of first sexual intercourse with most recent partner ( young men 9.9 % difference , 95 % confidence interval −18.7 to −1.0 ; young women 7.7 % difference , −16.6 to 1.2 ) . Pupils evaluated the intervention programme more positively , and their knowledge of sexual health improved . Lack of behavioural effect could not be linked to differential quality of delivery of intervention . Conclusions : Compared with conventional sex education this specially design ed intervention did not reduce sexual risk taking in adolescents This study tested the hypothesis that individual counselling in the third trimester would increase postpartum contraceptive use to a greater extent than only providing an educational leaflet . A total of 180 third trimester pregnant women of mean age 28.3 years who were attending Marmara University Hospital for prenatal care were enrolled . One-third were r and omly allocated to receive prenatal contraceptive counselling and the remaining two-thirds ( control group ) received an educational leaflet . Participants were followed-up at 6–9 months postpartum . The majority of subjects ( 91.5 % ) wanted to use contraception after delivery but 26.7 % did not know which method to use . At follow-up , 79.6 % of all women had begun a postpartum contraceptive regime and 68.7 % were using a modern contraceptive method . Overall , there was no statistically significant difference in postpartum contraception use between the control and intervention groups in this study population . It is , therefore , concluded that prenatal counselling was not superior to educational leaflets for increasing the use of effective and modern postpartum contraception OBJECTIVE The objective of the study was to determine whether a transtheoretical model-tailored expert system intervention increases dual- method contraceptive use , compared with a nontailored educational intervention . STUDY DESIGN We performed a r and omized clinical trial of 542 women at high risk for sexually transmitted infections ( STIs ) and unintended pregnancy . The intervention group received computer-based tailored feedback using a multimedia program . The control group received general contraceptive information and nontailored advice . RESULTS Participants in the intervention group were more likely to report use of dual contraceptive methods during follow-up ( adjusted hazard rate ratio 1.70 , 95 % confidence interval 1.09 , 2.66 ) , compared with controls . However , there were no differences in the rates of incident STI or unintended pregnancy between the 2 groups . CONCLUSIONS The computer-based transtheoretical model-tailored intervention result ed in a 70 % increase in reported dual- method contraceptive use in a group of women at high risk for STIs and unintended pregnancy . Inconsistent use of dual methods may explain the lack of effect on unintended pregnancy rates and incident STIs Recent efforts to involve patients more actively in therapeutic decisions have suggested the relevance of computer-based interventions at clinic visits . This paper presents a longitudinal , experimental study evaluating a computer-based contraceptive decision aid in Chicago and Madison family planning clinic visits . Patient interviews at three time points evaluated patient acceptance by  and  program impact on 949 young women . Both Chicago and Madison patients reported high acceptance . The program result ed in improved short-term knowledge and confidence in oral contraceptive ( OC ) efficacy for Chicago and Madison patients . In addition , compared to their control group , Madison experimental group patients had higher OC knowledge 1 year after the initial visit and a trend for fewer pregnancies ( P < 0.074 ) . Compared to their control group , a higher percent of the Chicago experimental group patients adopted OC 's after stating their intention to do so at the initial visit . Exposure to the computer program had no observable impact on the number of months on the oral contraceptive for Chicago or Madison patients . Overall findings suggest the usefulness of informatics tools as a supplement to patient-provider interactions The study examined the effect of pretreatment counseling upon discontinuation of 150 mg depo-medroxyprogesterone acetate ( Depo-Provera ( DMPA ) ) , given for contraception . A total of 421 Chinese women participated , 204 receiving detailed structured pretreatment and ongoing counseling on the hormonal effects and probable side effects of DMPA and 217 receiving only routine counseling .  The primary study endpoint was termination rate ; secondary endpoints were frequency of medical events and reasons for termination . Study termination rates were significantly lower in the intensive structured counseling group than in the routine counseling group . At one year , the total cumulative termination rates were 11 % ( 23/204 ) and 42 % ( 92/217 ) , respectively ( p < 0.0001 ) . The most common reasons for terminating DMPA were menstrual changes . No pregnancy , serious or unexpected medical events were reported , nor were statistically or clinical ly significant changes in vital signs observed . We conclude that pretreatment counseling on expected side effects increases the acceptability of DMPA ABSTRACT Objective To compare the effect of two types of counselling brochure on knowledge , attitudes and intention towards combined oral contraceptives ( COCs ) . Study design Double-blind , parallel-group r and omised trial conducted in Germany . Nulliparous women aged 18–24 years were r and omly assigned to receive one of two comprehensive information brochures about COCs , their benefits and risks , and alternative contraceptive methods . The first brochure was based on st and ard recommendations for evidence -based patient information ( EBPI ) . This was restructured and adapted according to the mental models approach ( MMA ) for the second brochure . The primary endpoint was the change in number of correct answers in a knowledge question naire administered directly after the intervention and three months later . The impact on attitudes and intention were secondary outcomes . Results Before the intervention , women answered 18.9 ( st and ard deviation [ SD ] 4.2 ) of 39 knowledge items correctly . After the intervention , the EBPI group ( n = 66 ; p = not significant ) improved by 7.6 ( SD 5.4 ) correct answers compared to 8.3 ( SD 5.8 ) in the MMA group ( n = 66 ) . After three months , the MMA group ( n = 60 ) maintained an improvement ( 5.0 [ SD 4.8 ] correct answers vs. pre-intervention measurement ) . In the EPBI group ( n = 64 ) , this value was 3.9 ( SD 5.6 ) . The change in correct answers was positively correlated with a change in attitude ( r = 0.284 , p = 0.001 ) and intention ( r = 0.212 , p = 0.015 ) . Conclusions The use of detailed evidence -based information brochures – irrespective of the underlying risk communication approach – can be recommended OBJECTIVE To evaluate the addition of structured contraceptive counseling to usual care on choice , initiation , and continuation of very effective contraception after uterine aspiration . METHODS We conducted a RCT of a version of the WHO Decision-Making Tool for Family Planning Clients and Providers with women having a procedure for a spontaneous or induced abortion . Our intervention provided structured , st and ardized counseling . We r and omized women to usual care or usual care with structured counseling . Our outcomes included choosing a very effective contraceptive method and 3 months continuation . RESULTS Fifty-four percent of all participants chose a very effective method . Women in the intervention group were no more likely to choose a very effective method ( OR 0.74 , 95 % CI 0.44 , 1.26 ) or to initiate their method compared to the usual care group ( OR 0.65 , 95 % CI 0.31 , 1.34 ) . In multivariate models , structured counseling was not associated with using a very effective method at 3 months ( AOR 1.06 , 95 % CI 0.53 , 2.14 ) . CONCLUSION In this setting , structured counseling had little impact on contraceptive method choice , initiation , or continuation . PRACTICE IMPLICATION S Adding structured counseling did not increase the proportion choosing or initiating very effective contraception in a practice setting where physicians already provide individualized counseling Abstract Objectives : To evaluate impact of postnatal health education for mothers  on infant care and postnatal family planning practice s in Nepal . Design : R and omised controlled trial with community follow up at 3 and 6 months post partum by interview . Initial household survey of study areas to identify all pregnant women to facilitate follow up . Setting : Main maternity hospital in Kathm and u , Nepal . Follow up in urban Kathm and u and a periurban area southwest of the city . Subjects : 540 mothers r and omly allocated to one of four groups : health education immediately after birth and three months later ( group A ) , at birth only ( group B ) , at three months only ( group C ) , or none ( group D ) . Interventions : Structured baseline household question naire ; 20 minute , one to one health education at birth and three months later . Main outcome measures : Duration of exclusive breast feeding , appropriate immunisation of infant , knowledge of oral rehydration solution and need to continue breast feeding in 
    Output:
    
Therefore , we can not say overall what would help consumers choose an appropriate contraceptive method .
In another trial , audiovisual aids worked better than the usual oral presentation .