Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years.
Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years.
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DOI：
10.1007/s10897-015-9874-0
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发表时间：
2016-04
影响因子：
1.9
通讯作者：
Thompson AA
中科院分区：
文献类型：
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作者：
Gallo AM;Wilkie DJ;Yao Y;Molokie RE;Stahl C;Hershberger PE;Zhao Z;Suarez ML;Johnson B;Angulo R;Carrasco J;Angulo V;Thompson AA
在镰状细胞病（SCD）或性状（SCT）人群中，辅助生殖健康决策的干预措施缺乏长期有效的证明。我们的目的是比较基于网络的多媒体教育项目CHOICES在实施知情生育计划方面的效果，以及常规护理教育（电子书）在24个月内对生育知识、意图和行为的影响。我们将234名SCD患者（n=138）或SCT患者（n=96）（年龄18-35岁，35%为男性，94%为非洲裔美国人）随机分为CHOICES组和电子书组。参与者在干预前和干预后（6,12,18和24个月）完成了四次镰状细胞特异性生殖测量。与电子书组相比，选择组随着时间的推移在知识方面有明显的改善（p= 0.004），但在意图（p= 0.18）或行为（p= 0.69）方面没有明显的改善。在基线时，114名（48.7%）参与者报告他们的伴侣不会让他们的孩子有遗传SCD的风险。在116名（49.6%）有风险的参与者中，选择组中选择在最后一次访问时降低风险的伴侣的比例高于电子书组（p=.04）。研究结果为设计一项全国性的选择性干预试验提供了重要的见解，该试验的重点是那些伴侣身份使他们有可能生下患有SCD的孩子的受试者。
Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n=138) or SCT (n=96) (age 18–35 years, 35% male, 94% African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p=.004) but not intention (p=.18) or behavior (p=.69). At baseline, 114 (48.7%) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6%) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p=.04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.