Does a postpartum "Green Star" family planning decision aid for adolescent mothers reduce decisional conflict? : A quasi-experimental study

AimTo our knowledge, there are still no studies in Tanzania regarding decision aids on long-acting reversible contraception. We evaluated the effects of our postpartum "Green Star" family planning decision aid on decisional conflict, knowledge, satisfaction, and uptake of long-acting reversible contraception among pregnant adolescents in Tanzania. MethodsWe used a facility-based quasi-experimental design with control. The participants were purposively recruited and randomly assigned (intervention, n = 33; control, n = 33). The intervention received the routine family planning counseling and decision aid. The control received only the routine family planning counseling. The primary outcome was change in decisional conflict measured using the validated Decisional Conflict Scale (DCS). The secondary outcomes were knowledge, satisfaction, and contraception uptake. We hypothesized that pregnant adolescents who use the decision aid will have a lower DCS score. ResultsWe recruited 66 pregnant adolescents; 62 completed the study. Participants in the intervention had a lower mean difference score in the DCS than participants in the control (intervention: -24.7 [SD 7.99] vs. control: -11.6 [SD 10.9], t = -5.53, p < 0.001). The mean difference score in knowledge was significantly higher in the intervention than in the control (intervention: 4.53 [SD 2.54] vs. control: 2.0 [SD 1.45], t = 4.88, p < 0.001). The mean score of satisfaction was significantly higher in the intervention than in the control (intervention: 100 [SD 0.0] vs. control: 55.8 [SD 30.7], t = 8.112, p < 0.001). Choice of contraception was significantly higher in the intervention [29 (45.3%)] than in the control [13 (20.3%)] (x2 = 17.73, p < 0.001). ConclusionThe postpartum "Green Star" family planning decision aid was useful as it lowered decisional conflict, improved knowledge and satisfaction with decision making, and enhanced contraception uptake. The decision aid demonstrated positive applicability and affordability for pregnant adolescents in Tanzania.