The development and pilot evaluation of an interactive computer-based program to help young people's contraceptive decision making - MyWay

This thesis focuses on the development of a contraceptive decision-analysis tool (MyWay) for young people and exploratory research to examine its application in a clinical setting. Decision analysis is essentially a method for breaking down complex problems or questions into manageable components, and then combining them quantitatively and logically to show the best course of action. The rationale for this work is that taking young people's current lifestyles and values into account when selecting and initiating a contraceptive method will increase user effectiveness and acceptability of the method, which will ultimately lead to a reduction in unplanned pregnancies and other negative outcomes, such as acquisition of sexually transmitted infections (STIs). MyWay works by combining the best available scientific evidence on the outcomes and effectiveness of available contraceptive options such as probability of pregnancy while on the pill, with quantitative assessments of the user's own preferences and values such as how they feel about the consequences of pregnancy. The under-lying decision-analysis model provides a ranking and rating of the various available options for each user, based on both scientific evidence and their own personal values. Best available evidence on each contraceptive method was collected on the following attributes (i.e. characteristics): (i) effectiveness in preventing pregnancy; (ii) risk of STI acquisition; (iii) other outcomes and factors affecting attractiveness including possible side effects (e.g. weight gain) and 'bother' considerations (e.g. having to go to a health service to obtain a contraceptive method). For the pilot study young people (10 men and 15 women) aged 13-21 years were to be introduced to the program during their consultation with the contraceptive nurse or doctor in a young people's sexual health clinic. The aim of the pilot was to assess the feasibility, acceptability and potential effectiveness of the MyWay program.EThOS - Electronic Theses Online ServiceGBUnited Kingdo