The Influence of Nurse Home Visits, Including Provision of 3 Months of Contraceptives and Contraceptive Counseling, on Perceived Barriers to Contraceptive Use and Contraceptive Use Self-Efficacy
Received 31 October 2007; received in revised form 10 July 2008; accepted 24 July 2008. published online 16 October 2008.
Objective
To identify the influence of a community health nurse (CHN) home visit on perceived barriers to contraceptive access and contraceptive use self-efficacy.
Methods
We enrolled 103 women into two groups in a randomized trial evaluating the influence of contraceptive dispensing and family planning counseling during home visits on perceived barriers to accessing contraceptives and contraceptive use self-efficacy. Both groups received counseling by a CHN about sexually transmitted disease and pregnancy prevention, and a resource card listing phone numbers of family planning clinics. After randomization, the CHN dispensed three months of hormonal contraception to the intensive intervention group and advised the minimal intervention group to schedule an appointment at a family planning clinic. Data collection at baseline and 12 months included demographic, reproductive and other health-related information as well as quantitative assessments of information on perceived barriers to contraceptive access and contraceptive use self-efficacy.
Results
The mean age of participants was 24.7 years. Three-fourths had household incomes under $25,000. We found significant reductions in three perceived barriers to contraceptive access for both groups, as well as significant increases in two measures of contraceptive use self-efficacy at twelve months compared to baseline.
Conclusion
Nurse home visits involving family planning counseling might be effective in reducing perceived barriers to contraceptive access and increasing contraceptive use self-efficacy.
aDepartment of Family Medicine, Oregon Health and Science University, Portland, Oregon
bDepartment of Public Health & Preventive Medicine, Oregon Health and Science University, Portland, Oregon
cDepartment of Public Health, Oregon State University, Portland, Oregon
Correspondence to: Alan L. Melnick, MD, MPH, Department of Family Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Mail Code: FM, Portland, OR 97239; Phone: 503-494-0756; Fax: 503-494-2746.
Supported by the National Institute of Child Health & Human Development (R01- HD042423-03) and the Family Medicine Research Program at the Oregon Health and Science University
ABSTRACT