Translational Science Benefits
Summary
The Contraceptive CHOICE Project is a large clinical trial research study whose goal is to increase uptake of long-acting reversible contraception and decrease unintended pregnancy in the St. Louis area. Jeffrey Peipert, MD, PhD, the Principal Investigator for the Contraceptive Choice Project, used support from the ICTS from 2007 to 2012 for KL2 scholars, TL1 trainees, and consultations with ICTS related to this Project
The Project involved nearly 10,000 women from the area, along with community partners and private providers.1 Providing no-cost contraception to teens in the CHOICE Project dramatically reduced the teen pregnancy and abortion rate in the St. Louis area. Of the 1,404 teens in the Project, 72% chose a Long-Acting Reversible Contraceptive (LARC) method. The teen pregnancy rate was 34.0 per 1,000 teens compared to the national average of 158.5 per 1,000 teens. Additionally, the abortion rate for teens in the CHOICE Project was 9.7 per 1,000 teens compared to the national average of 41.5 per 1,000 teens.2 Reduction of teen pregnancy rates is among the six identified CDC Winnable Battles for 2010–2015.3
The CHOICE Project is important from a clinical and translational aspect, as it represents a fundamental shift in the use of contraceptive methods and garnered significant attention from the community and media. The Project demonstrated that removing barriers to highly effective contraceptive methods such as IUDs and implants reduces unintended pregnancies by expanding patients’ access to their desired contraceptive methods.
Benefits
Demonstrated benefits are those that have been observed and are verifiable.
Potential benefits are those logically expected with moderate to high confidence.
New women’s community health center (C3) established, based on the Contraceptive Choice Project model of care. demonstrated.
Community
Project members have provided training to ACOG, CDC, Association of Reproductive Health Professionals, CHOICE-Australia. demonstrated.
Community
Local teen pregnancy rates and abortion rates were significantly below national average. demonstrated.
Community
The state of Missouri, as of 2018, saved an estimated $5 million in Medicaid costs. demonstrated.
Economic
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- McNicholas C, Madden T, Secura G. & Peipert JF. The contraceptive CHOICE project round up: what we did and what we learned. Clin. Obstet. Gynecol.57, 635–643 (2014).
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- Secura, G.M.et al. Provision of no-cost, long-acting contraception and teenager pregnancy. N Engl J Med.371, 1316–1323 (2014).
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- Centers for Disease Control and Prevention. Winnable Battles: Teen Pregnancy. [updated 2014 Nov 3; cited 2016 Oct 5]. Available from: http://cdc.gov/winnablebattles/teenpregnancy.
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- American Academy of Pediatrics. Contraception for adolescents. Pediatrics 134, e1244–e1256 (2014).
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- American College of Obstetricians and Gynecologists. Practice Bulletin No. 121: Long-acting reversible contraception: implants and intrauterine devices. Obstet. Gynecol.118,184–196 (2011).
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- Washington University in St. Louis. New women’s health clinic at Washington University [Internet].Wellness Connect. 2015 Oct. 6. [cited 2016 Nov 1]. Available from: http://wellnessconnection.wustl.edu/new-womens-health-clinic-at-washington-university.
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- University of Technology Sydney. Increasing the use of long-acting reversible contraception: The Australian Contraceptive ChOice pRoject (ACCORd) [Internet]. 2015 [cited2016 Nov 1]. Available from: http://cfsites1.uts.edu.au/find/projects/detail.cfm?ProjectId=2015000144.
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- Madden T, Barker AR, Huntzberry K, Secura GM, Peipert JF & McBride TD. Medicaid savings from the Contraceptive CHOICE Project: a cost-savings analysis. Am J Obstet Gynecol. 219(6): e1-e11. (2018).
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- Brief of the Guttmacher Institute and Professor Sara Rosenbaum as Amici Curiae in support of the Government, Burwell v. Hobby Lobby, 134 S. Ct. 2751, 573 US 189 (2014), (Nos. 13–354 & 13–356).