INFLUENCE OF NURSE-CLIENT CONTRACTING ON FAMILY PLANNING KNOWLEDGE AND BEHAVIORS IN A UNIVERSITY STUDENT POPULATION (REINFORCEMENT, CONTRACEPTION, PREGNANCY, PREVENTION, ADOLESCENT).
Contributors: University of Michigan.
Published: 1985
Number of pages: 148
Subjects: Health Sciences, Nursing.
Description: One hundred and fifty-two sexually active 18 to 22 year old female clients were randomly selected and randomly assigned to three groups at the student gynecology clinic of a large mid-western university. One group received routine clinic care and the second received routine clinic care, an educational component and contracting. The third group received routine clinic care, education and contracting, with client-selected reinforcers provided them for fulfilling contracts. Contracting is a process whereby the client, in consultation with a nurse, chooses to perform a specific health-related behavior and makes a written agreement to do so. The purpose of the educational component and contracting was to increase client knowledge about family planning and reduce their risk of having an unintended pregnancy.

Analysis of the data revealed a statistically significant increase in family planning knowledge for both contracting groups, but not for the control group. Consistency in use of contraception also increased significantly following the clinic visits for both contracting groups, but not for the routine clinic care/control group. Subjects who received reinforcers for fulfilling their contracts fulfilled more contracts, were more likely to say that the process of contracting was valuable, were more likely to discuss their contracts with others and to discuss birth control with sex partners than subjects who did not receive a reinforcer. A differential attrition rate was noted among study subjects, with those in the contracting without reinforcement group significantly more likely than the contracting with reinforcement group or the routine care group to leave the study before treatment was complete.

Implications for further research include questions about use of various forms of reinforcement to assist clients modify health behaviors related to reduction of risk for unintended pregnancy. Other areas for investigation include: extension of the family planning nurse-client contracting process to studies which involve multiple contracting nurses, multiple clinic settings, and adaptation of contracting for use with younger adolescents.
Notes: Source: Dissertation Abstracts International, Volume: 46-11, Section: B, page: 3787.

Thesis (PH.D.)--THE UNIVERSITY OF MICHIGAN, 1985.

School code: 0127.