title: Family planning and contraceptive decision-making by economically disadvantaged, African-American women.
abstract: BACKGROUND
  Significant racial disparities exist in the US unplanned pregnancy rate. We conducted a qualitative study using the theory of planned behavior as a framework to describe how low-income, African-American women approach family planning.
  
  
  METHODS
  Structured focus groups were held with adult, low-income, nonpregnant, African-American women in Connecticut. Data were collected using a standardized discussion guide, audio-taped and transcribed. Four independent researchers coded the transcripts using the constant comparative method. Codes were organized into overarching themes.
  
  
  RESULTS
  Contraceptive knowledge was limited, with formal contraceptive education often occurring after sexual debut. Attitudes about contraception were overtly negative, with method effectiveness being judged by the presence of side effects. Family and friends strongly influence contraceptive decisions, while male partners are primarily seen as a barrier. Contraceptive pills are perceived as readily accessible, although compliance is considered a barrier.
  
  
  CONCLUSIONS
  Contraception education should occur before sexual debut, should involve trusted family and community members and should positively frame issues in terms of achieving life goals.
authors.affiliation: Southeastern Connecticut Maternal-Fetal Medicine Associates, New London, CT 06320, USA. ejhodgsonmd@gmail.com
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hodgson
authors.forename: Charlene
authors.initials: C
authors.lastname: Collier
authors.forename: Laura
authors.initials: L
authors.lastname: Hayes
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Curry
authors.forename: Liana
authors.initials: L
authors.lastname: Fraenkel
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D003237:Connecticut; D003267:Contraception / Q000523:psychology / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D003276:Contraceptives, Oral; D003657:Decision Making; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011203:Poverty / Q000706:statistics & numerical data*; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012736:Sex Education; D012725:Sexual Behavior; D012747:Sexual Partners / Q000523:psychology
chemical_list: D003276:Contraceptives, Oral