Couple-based prenatal contraceptive education program for economically marginalized families

Project Summary/Abstract Economically marginalized individuals face multiple barriers to consistent desired contraceptive use. Inconsistent contraceptive use in the postpartum period is associated with unintended short interpregnancy intervals (SII). In fact, 70% of all SIIs are unintended and economically marginalized families are at higher risk

of unintended SIIs. SIIs increase the risk of poor postpartum mental and physical health outcomes such as preterm birth, postpartum depression, and maternal and infant morbidity and mortality. Contraceptive education is one solution to improving consistent desired contraceptive use and the subsequent unintended

outcomes. When provided prenatally, contraceptive education can increase contraceptive uptake and increase consistent utilization in the postpartum period. However, contraceptive education is not consistently provided due to time limitations and availability constraints of traditional prenatal appointments. Yet, when contraceptive

education is provided, it frequently misses opportunities to simultaneously intervene on the social (i.e., partner involvement, joint couple decision making and planning) and systemic barriers (i.e., paying utilities, job training, assistance navigating healthcare access to consistent contraceptive use).

Planning Together is a couple-based multi-level contraceptive education program to improve consistent desired contraceptive use postpartum via (a) reducing social barriers (i.e., harness existing support by including partner in the contraceptive education and optimize couple communication by teaching couple

communication skills to improve joint contraceptive decision-making and planning process) and (b) reducing structural barriers associated with SDOH that can negatively impact consistent desired contraceptive use. Additionally, Planning Together offers a flexible delivery method (asynchronous and synchronous components)

that will increase accessibility and scalability by the time constraints of economically marginalized families and healthcare providers. Specifically, we aim to develop the Planning Together protocol using community- engaged dyadic semi-structured interviews with pregnant couples and individual semi-structured interviews

with health profesionals to gain a variety of perspectives to increase the culturall responsiveness of the intervention to the needs of economically marginalized families. Second, we will test the acceptability, feasibility, and fidelity of the Planning Together protocol in a single-arm pilot test. Execution of these aims will

provide the first demonstration of the feasibility and acceptability of the Planning Together protocol. This project will provide the necessary pilot data for future NIH funding (R01). Planning Together has the potential to redesign existing family planning education modes to improve consistently desired couple contraceptive

usage, with the longer-term goal of reducing short interpregnancy intervals to improve the mental and physical health of economically marginalized families.