Pilot evaluation of an internet-based natural family planning education and  service program

Richard Jerome Fehring; Mary Schneider; Kathleen Raviele

doi:10.1111/j.1552-6909.2011.01237.x

Fertility Awareness Effectiveness

Pilot evaluation of an internet-based natural family planning education and service program

Fehring RJ, Schneider M, Raviele K

Published April 15, 2011 Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN, 40(3), 281-291

DOI 10.1111/j.1552-6909.2011.01237.x PMID 21488954

RRM Academy Synopsis

Online NFP pilot found a 2% unintended pregnancy rate with correct use

Among 222 women avoiding pregnancy in a 6-month online pilot, the unintended pregnancy rate was 2 out of 100 with correct use and 7 out of 100 with typical use. Fertility knowledge rose significantly from registration to one month of use.

Key Findings

Among 222 women avoiding pregnancy, two correct-use unintended pregnancies gave a 2% rate at 6 months of use, and seven total unintended pregnancies gave a typical use rate of 7%.
The six-cycle correct-use unintended pregnancy rate was 0% for the 114 nonbreastfeeding participants and 3.8% for the 108 breastfeeding participants, who had two unintended pregnancies.
Of 38 charting participants who wished to achieve a pregnancy at some point, 19 achieved a pregnancy.
Mean fertility knowledge on a 10-item true-false quiz rose from 8.96 at registration to 9.46 after 1 month of use among the 96 participants who completed both (t=4.60, p<.001).
Mean acceptability scores increased nonsignificantly from 45.6 at 1 month (143 respondents) to 48.4 at 6 months (40 respondents), on a scale from 10 to 70.

Interpretation

The study is a 6-month pilot evaluation of a Marquette University website with online fertility charting, discussion forums and nurse consultation. Of 468 registered volunteer women, 222 used the charting system to avoid pregnancy. A survival analysis (Kaplan-Meier) estimated the correct-use and typical use unintended pregnancy rates. The authors note that acceptability needs further study. They call for larger studies with more cycles of use.

RRM Context

The Marquette Method is a fertility awareness-based method (FABM). It uses a hormonal fertility monitor and cervical mucus charting. The online program builds body literacy, because women learn to recognize their own fertile window. The authors recommend a similar online charting system to test whether it helps women who have trouble getting pregnant to conceive.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To evaluate the efficacy, knowledge of fertility, and acceptability of a web-based natural family planning (NFP) education and service program.

Design

A 6-month repeated measure longitudinal evaluation pilot study.

Setting

A university based online website.

Participants

The website was piloted with 468 volunteer women seeking NFP services. Of these participants, 222 used the automatic online fertility charting system to avoid pregnancy. The 222 charting participants had a mean age of 29.9 years (SD=5.6), 2.2 children (SD=1.9), 37% were postpartum, and 47% had regular menstrual cycle lengths.

Intervention

Nurse-managed web-based NFP education and service program.

Outcomes

Pregnancies were confirmed by an online self-assessed pregnancy evaluation form. A 10-item fertility quiz and 10-item acceptability survey was administered online.

Results

Among the 222 users avoiding pregnancy, at 6 months of use, there were two correct-use unintended pregnancies that provided a pregnancy rate of 2% and seven total unintended pregnancies providing a typical use pregnancy rate of 7%. Mean knowledge of fertility increased significantly from time of registration (8.96, SD=1.10) to 1 month of use (9.46, SD=.10), t=4.60, p<.001). Acceptability increased nonsignificantly from 1 month of use (45.6; SD=8.98) to 6 months of use (48.4; SD=8.77).

Conclusion

The nurse-managed online NFP system seems to provide adequate knowledge of fertility and help participants meet pregnancy intentions. Acceptability of such a system of NFP is still in question.

Read the guide

Fertility Awareness Methods Compared

Topics

Fertility Awareness Effectiveness Typical and Perfect Use

Fertility Awareness › Effectiveness › Typical and Perfect Use

Richard Jerome Fehring, Mary Schneider, Kathleen Raviele

Rick Fehring, Dick Fehring, Rich Fehring, R Fehring, M Schneider, K Raviele

PMID 21488954 21488954 DOI 10.1111/j.1552-6909.2011.01237.x 10.1111/j.1552-6909.2011.01237.x Fehring et al. 2011, Fehring 2011