O-130: A randomized-controlled study of an online infertility psychoeducational program

Abstract

This study sought to develop an evidence-based, online psycho-educational program grounded in cognitive behavioral and social learning theories to provide a comprehensive educational experience for infertility patients. The study goal was to determine if an online psycho-educational program could positively influence problematic fertility beliefs and attitudes, decisional conflict, and self-efficacy in the management of fertility treatment. A randomized-control study with 297 fertility patients (188 females and 109 males) from 3 major US treatment centers. Female patients were the primary study participants; >50% of their partners were recruited for an exploratory study. Patients seeking fertility treatment were recruited via flyers posted at fertility clinics to participate in an online study about how patients cope with fertility treatment. Using a rigorous research design that controls for assessment affects, patients were randomized into one for four groups, two of which received the online psycho-educational program and two groups which did not. The assessment battery, which was delivered online at a secure web portal, included measures of perceived distress, attitudes and beliefs about fertility problems, decisional conflict, ways of coping, and infertility self-efficacy. Participants exposed to the online psycho-educational program were asked to spend two 45-minute sessions using the program, which included 4 media-rich modules on basic fertility facts, coping skills, partner and provider communication. An online follow-up assessment battery was administered at one-month after baseline. The Solomon 4 analysis revealed several important findings. Overall, participants in the intervention group decreased their “sexual concern” score on the Fertility Problem Inventory (p=.03), and improved their self-efficacy on the “body integrity” subscale of the Infertility Self-Efficacy Scale (p=.04). In spite of pre-assessment reactivity to “planful problem solving”, participants further increased their use of this coping style after viewing the intervention (p<.01). An effect was also observed for decisional conflict whereby decisions for which participants felt “uninformed” (p=.02) and “unclear” (p=.06) improved at post-test. By gender, the intervention resulted in less distress for women in the areas of sexual concerns (p=.04) and rejection of childfree lifestyle (p=.06), and improvements in infertility self-efficacy around body integrity and decisional conflicts initially perceived “uninformed” (p=.02). For the men in the intervention group, improvements were observed in the area of relationship concern (p<.05) and decisional conflict where “clarity” was perceived as needed (p=.07). An online psycho-educational support program may offer a viable adjunct service for fertility clinics to offer patients seeking a fertility evaluation or treatment, and may be particularly effective in teaching skills for problem solving and decision making. The confidential nature of an online program may also serve as an important approach in helping patients grapple with intimate matters related to one’s relationship and sexual concerns, especially for patients who do not have access to counseling services or do not feel comfortable raising these issues with medical staff.