Kelly, P. J., Witt, J., McEvers, K., Enriquez, M., Abshier, P., Vasquez, M., & McGee, E. (2012). Clinician perceptions of providing natural family planning methods in Title X funded clinics. Journal of Midwifery & Women's Health, 57(1), 35-42. https://doi.org/10.1111/j.1542-2011.2011.00107.x
Kelly PJ, Witt J, McEvers K, Enriquez M, Abshier P, Vasquez M, McGee E. Clinician perceptions of providing natural family planning methods in Title X funded clinics. J Midwifery Womens Health. 2012;57(1):35-42. doi:10.1111/j.1542-2011.2011.00107.x
Kelly, Patricia J., et al. "Clinician perceptions of providing natural family planning methods in Title X funded clinics." Journal of Midwifery & Women's Health, vol. 57, no. 1, 2012, pp. 35-42.
Title X clinicians say limited time and resources hinder NFP teaching
Title X clinicians appeared to agree that limited visit time is the main barrier to teaching natural family planning (NFP). In this 2012 focus group study, 29 clinicians from across the United States and Puerto Rico also named patient confusion about fertility and uneven teaching. In 2008, 1 out of 100 Title X patients relied on NFP.
Key Findings
Six telephone focus groups of 5 or 6 clinicians each (N = 29) lasted 45 to 90 minutes. Clinicians came from different clinics across the United States and Puerto Rico.
Participants shared two goals: teaching patients how the body works and enabling patients to learn to control their fertility.
Four subthemes emerged: patient misinformation about fertility, clinician ideas about candidates for NFP, inconsistent teaching strategies, and lack of time.
Participants judged adolescents, women with irregular periods, women outside monogamous relationships, and women with uninterested partners poor candidates. Those groups made up a large percentage of their patients.
In 2008, only 1% (10,409) of patients in Title X funded clinics relied on NFP for pregnancy prevention.
Interpretation
This qualitative study held phone focus groups with Title X clinicians and sorted their answers into themes about teaching NFP. The authors note their findings cannot be broadly generalized. The findings support larger studies of NFP teaching barriers in Title X clinics.
RRM Context
The authors say NFP can be part of planning a pregnancy, since knowing the fertile signs helps couples time conception. Restorative reproductive medicine is cycle-charting-informed. Participants reported limited clinician knowledge of NFP, little teaching time, and few patient materials. They also described community NFP courses that required a spouse to attend.
Our editorial summary of this paper, not the article's abstract.
Abstract
Introduction
Natural family planning (NFP) methods are effective for contraception with proper and consistent use. However, only 1% of patients at federally funded Title X family planning clinics select NFP as a contraceptive method. The goal of this study was to understand from clinicians' perspectives the barriers and facilitators to providing NFP methods.
Methods
Six telephone focus groups were conducted with 29 clinicians from Title X clinics across the United States and Puerto Rico. A hermeneutic method was used to analyze data for related themes.
Results
The overarching theme from the study was that participants had a strong desire to teach their patients how their bodies work and to empower them to learn to control fertility. Four subthemes emerged: patient misinformation and misunderstanding about fertility; provider ideas about ideal types of candidates for NFP; inconsistent patient teaching strategies; and lack of time to teach NFP methods.
Discussion
There is a need for increased NFP training for providers and efficient NFP patient teaching strategies to meet the needs of patients with limited knowledge about fertility.
Ethics and Policy › Advocacy and Public Understanding › Public Awareness · Body Literacy › Patient Education › Fertility Knowledge and Misconceptions · Clinician Education and Training › Practice Adoption › Implementation in Practice
Pat Kelly, Trish Kelly, P Kelly, J Witt, K McEvers, M Enriquez, Pat Abshier, Trish Abshier, P Abshier, M Vasquez, E McGee
PMID 22251910 22251910 DOI 10.1111/j.1542-2011.2011.00107.x 10.1111/j.1542-2011.2011.00107.x Kelly et al. 2012, Kelly 2012
Keywords
Adult, Ambulatory Care Facilities/economics, Attitude of Health Personnel, Education, Continuing, Family Planning Services/economics/methods, Female, Fertility, Financing, Government, Focus Groups, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Natural Family Planning Methods, Patient Education As Topic/methods, Puerto Rico, Sex Education/economics/methods, United States
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