Group versus individual contraceptive counseling for resettled African refugee women: a pilot randomized controlled trial

Abstract

Objectives: We aimed to evaluate the feasibility of group contraceptive counseling and its associations with family planning knowledge acquisition, service satisfaction, method uptake and continuation among a group of resettled African refugee women. Methods: We adapted materials for group contraceptive counseling from USAID resources. Individual contraceptive counseling using shared decision making was standard of care. Participants were recruited via community leaders and snowball referral methods. Following informed consent, participants completed a demographics survey and baseline contraceptive knowledge assessment (adapted from the Fog Zone study). Participants were then randomized to receive either group or individual counseling. Postcounseling, women were privately offered their choice of contraceptive method at no cost. Exit surveys reassessing knowledge and service satisfaction were administered. Knowledge acquisition was based on mean number of correct answers (range, 0–27). Service satisfaction was assessed with a 5-point Likert scale. Results: We conducted three sessions to recruit 17 participants who were randomized to receive group (n=8) or individual (n=9) counseling. Baseline knowledge was similar between groups (p=.12), while knowledge acquisition differed significantly between groups (p=.006); the mean number of correct answers increased from 11 to 19 among those who received group counseling and from 14 to 16 among the individual counseling group. Counseling satisfaction did not differ between groups. Modern contraceptive method uptake was greater in the individual counseling group: Five women initiated a method versus two women who received group counseling. Data collection on method continuation is ongoing. Conclusions: Group contraceptive counseling provides a novel approach to family planning provision, has a demonstrated ability to improve knowledge acquisition and is worthy of further investigation.