Natural Family Planning Research Grant: An Exploratory Study to

Enhance Understanding About the Use of Natural Family Planning

Methods in Title X Settings

Jacki Witt, Project DirectorPat Kelly, Co-investigator

Maithe Enriquez, Co-investigator

Supported by Grant # FDRPA006037-01-00, Office of Population Affairs, Office of Family

Planning, DHHS

UMKC School of Nursing

NFP Project StaffJacki Witt

Project Director

Pat KellyCo-Investigator

Maithe Enriquez Co-Investigator

TBDStudy Coordinator

Aimee BrockmanAdmin Asst

Susie MillerAdmin Asst

Student Research Asst TBD

Eve McGeeFacilitator

Patti Abshier

Facilitator

Aims of the Natural Family Planning Study

1) Explore knowledge, attitudes &institutional & socio-cultural factors that influence the promotion, instruction orreferral for natural family planning amongagencies, health care providers & clientswho are the beneficiaries of federalfunding

2) Make recommendations which willinform policy & clinical practices relatedTo NFP in federally funded clinics

The Theory of Planned Behavior

Study Design

Input from Beneficiaries

Design and Methodology

129 Preceptors in38 States and Washington, DC

Updated 11/9/08

Clinical Training Center for Family PlanningTrained Preceptors

9 Preceptors in Atlanta

Focus Group Facilitator GuideConstruct Question Probe(s)

Behavioral Beliefs

What are some of your concerns about discussing Natural Family Planning with clients?

Concerns about discussing any other method(s)? Concerns about incorporating Level 1 infertility services? Concerns about incorporating preconception counseling/pregnancy planning?

What are the advantages of NFP that you are aware of?

Disadvantages? Partner issues?Use as a pregnancy planning tool?

What referral sources are available in your community for clients wishing to use natural methods of contraception?

What do you do if someone asks for more information about natural family planning?

Normative Beliefs

Which people or groups of people influence the content or volume/amount of your contraceptive counseling?

How do you individualize your counseling?

Which people or groups of people would support you introducing NFP to married women?

How about single women?Adolescents?

Which people or groups of people influence which method of birth control your client chooses to use?

Professionals?Family members?Partners?

Control Beliefs

How much control would you say you have over which method of birth control your clients choose?

What factors make it difficult to offer natural family planning to clients?

What about other methods? Any difficulties?

What factors make it easy to offer natural family planning to clients? What about other methods?

Sample Consumer Survey Questions

• Is this your first visit to this clinic?– Yes– No

• Geographic setting where clinic is located:

– Rural– Small Town (<10,000 population)– City (10,000 – 99,999 population)– Urban (100,000-499,999population)– Metropolis (>500,000 population)

• For the purpose of this study, we define natural family planning (NFP), also called fertility awareness methods (FAM) as family planning methods that rely on identifying potentially fertile days in each menstrual cycle when intercourse is most likely to result in a pregnancy.

• Has a health care provider ever told you about natural family planning for preventing pregnancy (birth control)?– Yes– No

• Has a health care provider ever told you about natural family planning for trying to get pregnant (planning a pregnancy)?– Yes– No

• Using a seven (7) point scale where 1 means “strongly disagree” and 7 means “strongly agree” respond to the following statements about natural family planning.

• I understand when the fertile time (most likely to get pregnant) of the menstrual cycle is for women who have regular cycles.

1 2 3 4 5 6 7

• The most fertile time of the menstrual cycle (time when a woman is most likely to get pregnant) :– About 7-10 days after the first day of menstruation– About 12-14 days after the first day of menstruation – About 18-21 days after the first day of menstruation – None of the above– Don’t know or not sure

Qualitative Analysis Plan• Focus group proceedings will be taped and

then transcribed• Loaded into Atlas• Initial codes assigned (using contructs from

TPB)• Data grouped• Themes organized• Initial analysis verified by facilitators

Quantitative Analysis Plan

• SPSS• Descriptive Statistics

Impact Outcome