Motivational interviewing to improve postabortion contraceptive uptake by young women: development and feasibility of a counseling intervention.

OBJECTIVE: The objective was to develop and test a postabortal contraception counseling intervention using motivational interviewing (MI) and to determine the feasibility, impact and patient acceptability of the intervention when integrated into an urban academic abortion clinic. STUDY DESIGN: A single-session postabortal contraception counseling intervention for young women aged 15-24 years incorporating principles, skills and style of MI was developed. Medical and social work professionals were trained to deliver the intervention, their competency was assessed, and the intervention was integrated into the clinical setting. Feasibility was determined by assessing ability to approach and recruit participants, ability to complete the full intervention without interruption and participant satisfaction with the counseling. RESULTS: We approached 90% of eligible patients and 71% agreed to participate (n=20). All participants received the full counseling intervention. The median duration of the intervention was 29 min. Immediately after the intervention and at the 1-month follow-up contact, 95% and 77% of participants reported that the session was helpful, respectively. CONCLUSIONS: MI counseling can be tailored to the abortion setting. It is feasible to train professionals to use MI principles, skills and style and to implement an MI-based contraception counseling intervention in an urban academic abortion clinic. The sessions are acceptable to participants. IMPLICATIONS: The use of motivational interviewing in contraception counseling may be an appropriate and effective strategy for increasing use of contraception after abortion. This study demonstrates that this patient-centered, directive and collaborative approach can be developed into a counseling intervention that can be integrated into an abortion clinic.

First Report of Race 8 of Downy Mildew, Caused by Peronospora farinosa f. sp. spinaciae, of Spinach in the United States.

Downy mildew, caused by Peronospora farinosa f. sp. spinaciae, is the most economically important disease of spinach (Spinacia oleracea) in the United States and the European Union. In the United States, 23,000 ha of spinach, with a crop value of approximately $170 million, were grown during 2005 (1; http://www.nass.usda.gov/index.asp ). Additionally, per capita, fresh-market spinach consumption has increased 214% in the past decade (1; http://www.nass.usda.gov/index.asp ). Increased demand for fresh-market spinach has led to changes in spinach production practices such as higher planting densities and year-round production. There are currently 10 described races (races 1 to 10) of P. farinosa f. sp. spinaciae. Race 8 was recovered from the Netherlands in 2004 (B. M. Irish, J. Correll, S. T. Koike, and T. Morelock. Plant Dis. [In press]), but has not been previously identified in the United States. In February 2007, several commercial fresh-market spinach fields in central Arizona were severely affected with downy mildew. Symptoms consisted of bright yellow leaf lesions ranging in size from 1 to 3 cm in diameter that supported dense purple sporulation of the pathogen on the corresponding abaxial leaf surface. Affected fields were primarily planted with spinach cv. Parrot, which is reported to be resistant to races 1 to 7 and 9. As much as 32 ha were affected and disease incidence reached as high as 25 to 30%. An isolate (PAR1) of the pathogen was obtained and used to inoculate a standard set of 10 differential spinach cultivars for race identification as previously described (B. M. Irish, J. Correll, S. T. Koike, and T. Morelock. Plant Dis. [In press]). Briefly, a spore suspension (1 × 105 sporangia per ml) was misted onto test plants; plants were then incubated in a dew chamber (20°C, 100% relative humidity) for 24 h and maintained in a greenhouse. Inoculation tests were conducted at least twice at each of two different locations (Arkansas and California), with each test including two replications of 15 plants per differential cultivar. The selective development of downy mildew on specific differentials indicated that the isolate was race 8 (B. M. Irish, J. Correll, S. T. Koike, and T. Morelock. Plant Dis. [In press]). To our knowledge, this is the first report of race 8 in the United States. Since there are a number of commercial spinach cultivars available with resistance to race 8, the economic impact of this race in the United States is expected to be low if resistant cultivars are grown (B. M. Irish, J. Correll, S. T. Koike, and T. Morelock. Plant Dis. [In press]). Reference: (1) R. N. Acharya and I. Molina. NFAPP Newsl. Second Quarter, 2005.