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Hum. Reprod. Advance Access originally published online on December 18, 2007
Human Reproduction 2008 23(3):554-566; doi:10.1093/humrep/dem306
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Online psychoeducational support for infertile women: a randomized controlled trial

Tara M. Cousineau1,3,8, Traci C. Green2, Evelyn Corsini3, A Seibring1, Marianne T. Showstack4, Linda Applegarth5, Marie Davidson6 and Mark Perloe7

1 Domar Center for Mind-Body Health, Boston IVF, Inc. 130 Second Avenue Waltham, MA 02451 2 Yale School of Public Health, 60 College Street, P.O. Box 208034, New Haven, Connecticut 06520 3 Inflexxion Inc, 320 Needham Street, Newton, MA 02464 4 University of Massachusetts - Boston 100, Morrissey Boulevard, Boston, MA 02125 5 The Center for Reproductive Medicine and Infertility Weill-Cornell Medical College - NY Presbyterian Hospital, 1305 York Avenue, 6th Floor, New York, NY 10021 6 Fertility Centers of Illinois, 3703 W. Lake Avenue, Suite 106, Glenview, IL 60025 7 Georgia Reproductive Specialists, 5445 Meridian Mark Road, Suite 270, Atlanta, GA 30342

8 Corresponding author. E-mail: cousineau{at}domarcenter.com

BACKGROUND: The study goal was to develop and test the effectiveness of a brief online education and support program for female infertility patients.

METHODS: A randomized-controlled trial was conducted. Using a Solomon-four group design, 190 female patients were recruited from three US fertility centers and were randomized into two experimental and two no-treatment control groups. The psychological outcomes assessed included infertility distress, infertility self-efficacy, decisional conflict, marital cohesion and coping style. Program dosage and satisfaction were also assessed at four weeks follow-up.

RESULTS: Women exposed to the online program significantly improved in the area of social concerns (P = 0.038) related to infertility distress, and felt more informed about a medical decision with which they were contending (P = 0.037). Trends were observed for decreased global stress(P = 0.10), sexual concerns (P = 0.059), distress related to child-free living (P = 0.063), increased infertility self-efficacy (P = 0.067) and decision making clarity (P = 0.079). A dosage response was observed in the experimental groups for women who spent >60 min online for decreased global stress (P = 0.028) and increased self efficacy (P = 0.024).

CONCLUSIONS: This evidence-based eHealth program for women experiencing infertility suggests that a web-based patient education intervention can have beneficial effects in several psychological domains and may be a cost effective resource for fertility practices.

Key words: distress/eHealth/infertility/internet/self-efficacy

Submitted on December 15, 2006; resubmitted on June 27, 2007; accepted on August 13, 2007.


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