Smith, K. R., & Stanford, J. B. (2000). Characteristics of women associated with continuing instruction in the Creighton Model Fertility Care System. Contraception, 61(2), 121-129. https://doi.org/10.1016/s0010-7824(00)00084-6
Smith KR, Stanford JB. Characteristics of women associated with continuing instruction in the Creighton Model Fertility Care System. Contraception. 2000;61(2):121-129. doi:10.1016/s0010-7824(00)00084-6
Smith, K. R., and J. B. Stanford. "Characteristics of women associated with continuing instruction in the Creighton Model Fertility Care System." Contraception, vol. 61, no. 2, 2000, pp. 121-129.
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Three-fourths of new Creighton Model users reach four follow-up visits
Of 1458 new Creighton Model (CrMS) users at eight United States centers, 75.7% completed four or more follow-up visits in this retrospective cohort. Continuation was more likely among white women and college graduates. Women stopping oral contraceptives or breastfeeding were also more likely to continue.
Key Findings
Among 1458 women, 75.7% completed four or more CrMS follow-up visits, 64.7% completed five or more, and 29.6% completed eight or more.
In logistic regression, completing four or more visits was more likely among college graduates (odds ratio 1.47, 95% CI 1.14, 1.91) and white women (odds ratio 1.56, 95% CI 1.03, 2.37).
Women at teaching center cluster C were more likely to complete four or more visits than women at cluster A (odds ratio 2.37, 95% CI 1.71, 3.32).
Women who entered intending to achieve pregnancy were less likely to complete four or more visits than women temporarily avoiding pregnancy (odds ratio 0.56, 95% CI 0.40, 0.78).
Age, marital status, reproductive history, past use of other methods, and characteristics of the male partner were not independently associated with continuing instruction.
Interpretation
The retrospective cohort followed new CrMS users from 1990 through 1996 at eight centers in five United States cities. The outcome was attendance at follow-up instruction visits. Logistic regression and a Cox proportional hazards model estimated the associations. Most participants were white (88.7%), Catholic (71.5%), and educated beyond high school (81.9%). The authors note that many women who discontinue instruction continue to use the CrMS.
RRM Context
Creighton Model instruction teaches women and couples to recognize their days of potential fertility. Individual follow-up visits support that learning. The method serves women who want to avoid pregnancy and women who want to conceive. The authors suggest that longer instruction among women stopping oral contraceptives reflects greater need for assistance while cycle abnormalities take a number of cycles to resolve.
Our editorial summary of this paper, not the article's abstract.
Abstract
Effective use of natural family planning is strongly dependent upon adequate instruction. The Creighton Model Fertility Care System (CrMS) has a standardized protocol for instruction of new users that includes individual follow-up visits in the first year of use. This study evaluated the number of follow-up visits completed by new CrMS users from eight CrMS centers in the United States. Four follow-up visits were completed by 75.7% of women. Women who continued instruction were more likely to be educated, Catholic, and white, and to have a more challenging reproductive status (discontinuing oral contraceptives, or breastfeeding). These results suggest that the number of follow-up visits needed varies among new CrMS users. Future research should address the optimal length of instruction for adequate use of the CrMS by women with different characteristics and needs.
Fertility Awareness › Use and Experience › Method Teaching · Restorative Reproductive Medicine › NaProTechnology › Program Outcomes
Joseph B Stanford, Ken R Smith
Joe Stanford, Joey Stanford, J Stanford, Kenneth Smith, K Smith
PMID 10802277 10802277 DOI 10.1016/s0010-7824(00)00084-6 10.1016/s0010-7824(00)00084-6 Smith et al. 2000, Smith 2000
Keywords
Adolescent, Adult, Breast Feeding, Cohort Studies, Educational Status, Family Planning Services/education/methods, Female, Humans, Male, Marital Status, Middle Aged, Models, Educational, Natural Family Planning Methods, Parity, Patient Compliance/ethnology, Proportional Hazards Models, Regression Analysis, Religion and Sex, Retrospective Studies, Social Class, White People, Americas, Cervical Mucus Method, Developed Countries, Education, Family Planning, Family Planning Education, Family Planning, Behavioral Methods, Natural Family Planning, North America, Northern America, Research Report, United States
03r0ha626 