Influence of "Decide + Be Ready" Contraceptive Decision Aid on Pre-deployment Health Decisions.

Abstract

The number of active duty servicewomen and the career opportunities available to them continue to increase. Of the approximately 350,000 women in uniform, 97% are estimated to be of reproductive age, underscoring the importance of reproductive health care. This study aimed to explore the influence of the Decide + Be Ready (DABR) contraceptive decision aid on providing contraceptive knowledge, facilitating a servicewoman's contraceptive choice before and during deployment, and enabling understanding of individual preferences around contraception in a population of active duty women most at risk for unintended pregnancy. We conducted a qualitative study, recruiting active duty women between the ages of 17 and 24 with at least one prior deployment who were stationed at Naval Station Norfolk and presented for evaluation at a primary care clinic. Participants downloaded and reviewed the DABR application. A semi-structured interview was conducted and audio-recorded. Interviews were transcribed and underwent thematic analysis. Twenty women participated in the study over 2 weeks. Analysis revealed three overarching themes: perceived utility of and attitudes toward DABR, knowledge of and comfort with contraceptive options, and challenges specific to active duty women. In total, eight subthemes were also identified and explored. The DABR app provided study participants with new information about contraception. Participants reported improved knowledge of gynecologic and reproductive health options available during deployment. Other findings raise interest for future studies exploring incorporation of peer validation in counseling and decision-making tools, challenges with the deployed environment for obstetric/gynecologic health, and medical support on naval deployments.