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Clinician Perceptions of Providing Natural Family Planning Methods in Title X Funded Clinics


  • Patricia J. Kelly PhD, MPH, APRN,

  • Jacki Witt JD, MSN, WHNP-BC,

  • Kimberly McEvers MPH,

  • Maithe Enriquez PhD, APRN,

  • Patricia Abshier MPH,

  • Magda Vasquez MD,

  • Eve McGee MSW

Patricia J. Kelly, PhD, MPH, APRN, University of Missouri-Kansas City, School of Nursing, 2464 Charlotte Street, Kansas City, MO 64108. E-mail:


Introduction: Natural family planning (NFP) methods are effective for contraception with proper and consistent use. However, only 1% of patients at federally funded Title X family planning clinics select NFP as a contraceptive method. The goal of this study was to understand from clinicians’ perspectives the barriers and facilitators to providing NFP methods.

Methods: Six telephone focus groups were conducted with 29 clinicians from Title X clinics across the United States and Puerto Rico. A hermeneutic method was used to analyze data for related themes.

Results: The overarching theme from the study was that participants had a strong desire to teach their patients how their bodies work and to empower them to learn to control fertility. Four subthemes emerged: patient misinformation and misunderstanding about fertility; provider ideas about ideal types of candidates for NFP; inconsistent patient teaching strategies; and lack of time to teach NFP methods.

Discussion: There is a need for increased NFP training for providers and efficient NFP patient teaching strategies to meet the needs of patients with limited knowledge about fertility.