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.
