Choosing and Using Contraceptives: Integrating Qualitative and Quantitative Research Methods in Family Planning

In England the Wessex Regional Health Authority and the Department of Health commissioned an integrated study of the perceptions of the public general practitioners (GPs) and specialized family planning clinics (FPCs) to determine those areas where the family planning (FP) service was not meeting the needs of the public. The researchers held 19 focus groups consisting of female and male users of FP and nonusers from urban and rural areas of Wessex. Group moderators of the same sex and age as group participants introduced the following topics to facilitate discussion: sources of knowledge of contraception expectations and demands for the provision of contraceptives the choice of different methods of contraception and opinions of and recommendations for improved advertisement of contraceptive provision. The focus groups provided considerable information on the decision making processes expectations and experiences of contraceptive users and potential users. Participants wanted better information on the range of contraceptives available more advice about the effectiveness and potential side effects of methods and clear instructions about method use so they could have an improved choice when deciding on a contraceptive method. The researchers used the results of the focus groups to design a questionnaire for GPs FPC physicians and FPC nurses. The main topics of each questionnaire included information about the range of services currently provided and the type of advice and provision evaluation by providers of possible changes in provision developed from focus group discussions an assessment of providers perceptions of FP provision and basic information about experience and training. Most questionnaire respondents wanted to deliver quality FP services. Questionnaire results substantiated the need for further training among many GPs. Most FPC staff believed that they provided effective counseling but focus groups did not show this to be the case. Young women preferred a female physician under 40. Study findings resulted in recommendations ranging from effective marketing of FP services to broadening the role of nurses in FP provision.