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Randomized Controlled Trial of a Tubal Sterilization Decision Aid Among Medicaid Enrollees

Effects on Intended Contraceptive Method and Decision-Making Satisfaction

Dados Bibliográficos

ID23310339
AutoresElizabeth A Mosley (0000-0001-9534-2457, University of Pittsburgh, autor correspondente), Nikki Zite (University of Tennessee at Knoxville), Christine Dehlendorf (0000-0001-7303-5413, University of California, San Francisco), Kaleab Z Abebe (0000-0002-3644-8419, University of Pittsburgh), Nicole Luche (University of Pittsburgh), Catherine Wright (0000-0003-3422-2413, University of Pittsburgh), Michaella Wu (0000-0003-3666-168X, University of Pittsburgh), Sonya Borrero (0000-0001-9355-6654, University of Pittsburgh)
Ano2026
Data de publicação2026-07-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoWomen s Health Issues (JOURNAL)
Identificadores do periódicoISSN: 1049-3867 • E-ISSN: 1878-4321
EditoraElsevier BV (PUBLISHER)
DOI10.1016/j.whi.2026.06.009
PMID42509044
OpenAlexW7171361363
IdiomaEN
Referências citadas13

INTRODUCTION: Tubal sterilization is a permanent contraceptive method, yet misconceptions about its permanence are prevalent, and its history is marked by both coercion and barriers to access-particularly among Medicaid enrollees. Decision aids may help to support more informed, value-concordant decision-making. METHODS: From March 2020 to November 2023, English- and Spanish-speaking pregnant Medicaid enrollees at less than 24 weeks' gestation were randomized to either receive or not receive a novel web-based tubal sterilization decision aid. Participants completed surveys after randomization (control group) and after the decision aid (intervention group) at time point 1 (T1), in the third trimester (T2), and at 3 months postpartum (T3). Positive impacts of the decision aid on the primary outcomes of tubal sterilization knowledge and decisional conflict were previously reported. Secondary outcomes analyzed were intended contraceptive method at T1 (sterilization vs. other/no method) and satisfaction with the contraceptive decision-making process at T3. RESULTS: We included 350 pregnant Medicaid enrollees who completed surveys at T1, 301 who completed them at T2, and 286 who completed them at T3. There were no statistically significant differences between the decision aid and control groups in the intention to use tubal sterilization (55.6% vs. 61.24%; p = .238) or optimal contraceptive decision-making satisfaction (59.2% vs. 54.9%; p = .406). CONCLUSION: Although the decision aid was previously shown to improve sterilization decision quality, it did not appear to influence intended contraceptive method immediately after use of the tool during pregnancy or satisfaction with contraceptive decision-making.

Decision aids · Family planning · Medicaid · Population · Randomized controlled trial · Sterilization (economics) · Gynecological conditions and treatments · Reproductive Health and Contraception · Reproductive tract infections research

  • Reproductive Justice

    Zakiya Luna, Kristin Luker•Annual Review of Law and Social…•2013

  • Sterilization in US Immigration and Customs Enforcement’s (ICE’s) Detention

    Elizabeth C Ghandakly, Rachel Fabi•American Journal of Public Health•2021

  • California’s Sterilization Survivors

    Alexandra Minna Stern, Nicole L Novak et al.•American Journal of Public Health•2017

  • Sterilized in the Name of Public Health

    Alexandra Minna Stern•American Journal of Public Health•2005

  • "When Is Health Care Actually Going to Be Care?" The Lived Experience of Family Planning Care Among Young Black Women

    Open Access•Rachel G Logan, Ellen M Daley et al.•Qualitative Health Research•2021

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