# MyPath: A Patient-Centered Web-Based Intervention to Improve Reproductive Planning for Women Veterans

> **NIH VA I01** · VA PUGET SOUND HEALTHCARE SYSTEM · 2024 · —

## Abstract

Background: High rates of medical and mental health comorbidities result in elevated risks of poor maternal
and neonatal outcomes among women Veterans compared to their civilian counterparts. Proactive planning
and optimization of physical and mental health prior to pregnancy can mitigate these risks; however, nearly
40% of pregnancies among Veterans are unintended. National guidelines recommend routine delivery of
patient-centered reproductive planning services in primary care, including assessment of reproductive goals
followed by tailored contraceptive and/or preconception counseling, to reduce unintended pregnancy and
improve pregnancy outcomes. Only 38% of women Veterans at risk of pregnancy, however, report having
contraceptive or preconception health discussions with their primary care provider in the past year. We
developed “MyPath,” a novel patient-facing web-based decision support tool, to address gaps in reproductive
planning services in VA primary care. MyPath’s objectives are to help women Veterans consider their
reproductive goals, increase their knowledge, align contraceptive and pregnancy timing decisions with their
goals and health needs, and engage in shared decision making with providers. In pilot testing among 58
Veterans, use of MyPath prior to clinic visits was highly acceptable to Veterans and increased reproductive
planning discussions compared to usual care without increasing providers’ perceived workload. MyPath use
was also associated with increased decision quality and effective contraceptive use. Additional evaluation of
MyPath in a pragmatic randomized trial is needed to assess effectiveness and collect implementation data.
Significance/Impact: Patient-centered, scalable interventions that can enhance delivery of VA reproductive
planning services without creating burden on primary care providers are urgently needed. The MyPath
intervention leverages interactive patient-facing technology to empower women to make high-quality informed
decisions and engage with providers about their reproductive health needs. If found to be successful, MyPath
will lead to increased access to patient-centered reproductive planning services in VA primary care, addressing
key HSR&D priorities, including access, primary care practice, women’s health, and whole health.
Innovation: MyPath is the first online decision support tool designed to promote patient-centered reproductive
planning services in primary care settings and to facilitate high-quality decisions aligned with reproductive
goals. We will deliver the tool using the innovative strategy of partnering with the national VEText program to
send the MyPath link to Veterans before appointments in an automated text message appointment reminder.
Specific Aims: 1) Aim 1 will test the effect of the MyPath tool used before primary care visits on occurrence of
reproductive planning discussions with shared decision making (primary outcome), patient-provider
communication self-efficacy, and cont...

## Key facts

- **NIH application ID:** 10954262
- **Project number:** 5I01HX003123-04
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Lisa Susanne Callegari
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-10-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10954262

## Citation

> US National Institutes of Health, RePORTER application 10954262, MyPath: A Patient-Centered Web-Based Intervention to Improve Reproductive Planning for Women Veterans (5I01HX003123-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10954262. Licensed CC0.

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