Dual-method use is known as the most reliable protection against unintended pregnancies and sexually transmitted infections, including HIV. However, it is not commonly used in sub-Sharan Africa, especially among women using highly effective contraceptives. This article describes a protocol to evaluate the effect of an intervention formulated under the positive deviance approach for promoting dual-method use in Uganda. A total of 150 women will be interviewed using a structured questionnaire to find those practicing dual-method use. In-depth interviews will then be conducted with all women using the dual method and 10 women using only highly effective contraceptives to identify their unique practice. Then, a cluster randomized controlled trial will be conducted to examine the effect of an intervention formulated under the positive deviance approach on dual-method uptake and adherence. Twenty health facilities will be randomized to an intervention or control arm and 480 women will be enrolled in each group. The participants will be followed up for 8 months. This trial focuses on women who already adapted dual-method use and identifies their unique solutions to promote dual-method use. This trial could tackle barriers for dual-method use, which expert outsiders may fail to recognize, by analyzing and promulgating their unique behaviors. This study could provide evidence that the positive deviance approach can address unintended pregnancies and sexually transmitted infections as well as other health problems which usual approaches have failed to address. UMIN-CTR Clinical Trial, UMIN000037065. Registered on 14 June 2019.

中文翻译：

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乌干达妇女双方法促进的积极偏差：一项集群随机对照试验的研究方案

双重使用方法被公认为防止意外怀孕和包括HIV在内的性传播感染的最可靠保护。但是，它在撒哈拉以南非洲地区并不普遍使用，尤其是在使用高效避孕药的妇女中。本文介绍了一种协议，用于评估在积极偏差方法下制定的干预措施在乌干达促进双重使用的效果。总共150名妇女将使用结构化问卷进行访谈，以发现那些使用双重方法的妇女。然后将对所有使用双重方法的妇女和仅使用高效避孕药的10名妇女进行深入访谈，以查明她们的独特做法。然后，将进行一项整群随机对照试验，以研究采用正偏差方法制定的干预措施对双方法摄取和依从性的影响。20个医疗机构将随机分配给干预或控制部门，每组将招募480名妇女。参与者将得到为期8个月的随访。该试验的重点是已经采用双方法使用的妇女，并确定了他们促进双方法使用的独特解决方案。该试验可以通过分析和公布其独特行为来解决双重方法使用的障碍，而专家们可能无法识别双重方法。这项研究可以提供证据，积极偏离方法可以解决意外怀孕和性传播感染以及其他常规方法无法解决的健康问题。UMIN-CTR临床试验，UMIN000037065。于2019年6月14日注册。