Effectiveness of evidence-based medicine on knowledge, attitudes, and practices of family planning providers: A randomized experiment in Jordan

Background: Provider misconceptions and biases about contraceptive methods are major barriers to famil planning access for women in low-and middle-income countries, including Jordan. Evidence-Based Medicin (EBM) programs aim to reduce biases and misconceptions by providing doctors with the most up-To-date scientifi evidence on contraceptive methods Methods: We evaluate the effects of an EBM program conducted in Jordan on private providers' knowledge attitudes, and practices. Family planning providers randomly assigned to a treatment group were invited t attend a roundtable seminar on the injectable contraceptive Depot Medroxy Progesterone Acetate (DMPA) and to receive two 15 min one-on-one educational visits that reinforce the messages from the seminar Results: There was low compliance with the EBM program. The study fails to detect an impact on providers knowledge of DMPA's side effects or on reported clinical practices. There is suggestive evidence of a positiv impact on providers' attitudes toward and confidence in prescribing the contraceptive to their patients. There i also evidence of positive selection into program participation Conclusions: We conclude that EBM may not be effective as a stand-Alone program targeting a family plannin method with a high level of provider and consumer bias. Evidence of positive selection into program participatio underscores the importance of randomization to avoid overestimating the true effects of interventions Trial registration: AEA RCT Registry, AEARCTR0000539, 11/3/201.