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Document Type

Dissertation - University Access Only

Award Date


Degree Name

Doctor of Philosophy (PhD)


Graduate Nursing

First Advisor

Nancy Fahrenwald


unintended pregnancy


Objective. The purpose of this study was to conduct a pilot study to evaluate the effectiveness of a multi-media preventative reproductive health counseling (PRHC) intervention for women attending a family planning clinic. The PRHC intervention was designed to increase reproductive, contraception, and preconception health knowledge as well as create an opportunity through utilizing a reproductive life plan (RLP) in a clinic setting for healthcare providers to partner with their clients in meeting their personal reproductive goals. Background. Despite many favorable outcomes related to health in the United States during the 20th century, our maternal and infant mortality rates continue to be higher than other countries with similar health costs and healthcare systems (Murphy, Xu, & Kochanek, 2007). In addition, infants with low birth weight and those with pre-term birth have risen every year since the year 2000 (American College of Obstetrics and Gynecology [ACOG], 2006). Our nation’s rate of unintended pregnancies may hold the key to improving maternal and infant mortality rates. Fifty percent of our nation’s pregnancies are declared unintended (Noone & Younge, 2009).
Method. A randomized control design was used to explore the feasibility and effectiveness of implementing a multimedia reproductive health counseling (RHC) intervention in a family planning clinic. Instruments used for measurement in the study included contraception knowledge (CK) and contraception self-efficacy (CSE).
Results. The CK mean difference score for the control group was M = 0.09; SD = 1.66 and the intervention group M = 1.10; SD = 1.82 and there was a statistically significant difference at a p < .05 level in the mean difference between groups for CK, t (84) = 2.7, p = 0.008, d = 0.58. The CSE mean difference score for the control group was M = 0.33; SD = 4.25 and the intervention group M = 0.55; SD = 7.31. There was no statistically significant difference in the mean difference between groups for CSE, t (60) = 0.17, p = 0.86, d = .04. The multiple regression ran to predict CK from age, education, family structure, and income predicted CK, F (8, 78) = 2.297, p = 0.029, R² = 0.19. The multiple regression analysis for CK revealed education to be a significant predictor variable in the model at the p < .05 level [F (1, 78) = 7.97, p = 0.01] and annual income as a whole to be a significant predictor variable in the model [F (2, 78) = 4.79, p = 0.01]. There were no relationships identified through the multiple regression between CSE and any of the variables in the model with p-values ranging from 0.50 to 0.98 and F (8, 78) = .151, p = 0.996, R² = .0153.
Conclusion. The intervention in this study did cause a statistically significant increase in CK but did not cause a statistically significant increase in CSE. Secondary education and income were the only relationships identified in regression models to be associated with CK. The exploration of the effectiveness and feasibility of a PRHC intervention did offer an alternative to offering RHC in a family planning clinic. More research is needed to explore different populations and instruments using a similar PRHC intervention.

Library of Congress Subject Headings

Family planning Communication in public health Reproductive health services Contraception Health counseling


Includes bibliographical references (pages 91-102)



Number of Pages



South Dakota State University


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