# Development, Testing and Health Effects of a Multilevel Family Planning Intervention

> **NIH NIH R21** · UNIVERSITY OF TEXAS SAN ANTONIO · 2020 · $210,175

## Abstract

Abstract
In 2018, 32.6% of women of reproductive age had an unmet need for family planning in Uganda, meaning they
wanted to avoid pregnancy but were not using a modern contraceptive method. Filling the unmet need for
family planning has important public health implications, including reductions in pregnancy-related health risks
and deaths, and infant mortality. While Uganda is scaling up efforts to reduce supply-side barriers in rural
areas, such as community distribution of contraceptives, couples are still faced with multi-level demand-side
barriers to contraceptive use. In addition to misinformation and fear of contraceptive side-effects, relationship
dynamics, peer and family influence, and broader community norms promoting large family size and traditional
gender roles influence family planning. We propose to develop and pilot test a multi-level, community-based
intervention, which employs transformative community dialogues to alter individual attitudes and the perception
of community norms that discourage family planning. Community dialogues are delivered to groups of couples
over 4-sessions enhanced to simultaneously address individual and interpersonal-level determinants of family
planning and link couples to family planning services. The aims of our project are to: Aim 1) Develop a multi-
level intervention that engages couples in transformative community dialogues to reduce unintended
pregnancy by increasing modern contraceptive use. We will develop the intervention through qualitative
research with women and men with an unmet need and community stakeholders and through the formation of
a community intervention steering committee; Aim 2) Conduct a pilot quasi-experimental controlled trial with 70
couples (intervention n=35, control n=35), randomizing one village to the multi-level intervention (n=35
couples) and one village to the control condition (n=35 couples, attention-matched control intervention). We will
assess acceptability and feasibility of the trial procedures (Aim 2a) and intervention content (Aim 2b), with the
exploratory aim (2c) of assessing the intervention's potential efficacy on contraceptive uptake and continuation
and intermediate outcomes (knowledge, attitudes, perceived community norms, partner communication and
equity) through 6-month follow up.

## Key facts

- **NIH application ID:** 9894336
- **Project number:** 1R21HD098523-01A1
- **Recipient organization:** UNIVERSITY OF TEXAS SAN ANTONIO
- **Principal Investigator:** Susan Maria Kiene
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $210,175
- **Award type:** 1
- **Project period:** 2020-01-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9894336

## Citation

> US National Institutes of Health, RePORTER application 9894336, Development, Testing and Health Effects of a Multilevel Family Planning Intervention (1R21HD098523-01A1). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/9894336. Licensed CC0.

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