Birth Spacing and Family Planning: Implementation of enhanced education and training for Community Health Coaches

Abstract


 Background: Indiana is ranked 43/50 for infant mortality in America. WeCare employs lay Community Health Coaches (CHCs) to promote positive behavioral changes in pregnant, postpartum and women of child-bearing age living in low-income, high-risk communities in order to reduce the risk of infant mortality. Infant mortality can be reduced in communities where birth spacing and family planning education are available. 
 Project Methods: The goal was to address the knowledge gaps in patient handouts and CHC training regarding birth spacing and family planning. Through extensive literature searches, case conferences with CHCs, and review of current training materials, five gaps in training were identified: (1) comprehensive knowledge of rapid repeat pregnancies (2) resources regarding contraceptive methods (3) contraceptive counseling in the antenatal and postpartum periods (4) joint decision-making models and (5) father involvement in family planning. 
 Results: With comprehensive literature reviews and collaboration with fellow WeCare members, the gaps in training were appropriately filled. The WeCare training manual for CHCs is updated with information regarding birth spacing and family planning, as well as with counseling techniques for contraceptive method decision-making. A gap in existing literature regarding father involvement in family planning was identified. 
 Conclusion and Potential Impact: By enhancing CHC education on birth spacing, family planning, and counseling techniques, we may begin to close the knowledge gap for women in low-income, high-risk populations. This has the potential to reduce the rate of rapid repeat pregnancies and unintended pregnancies. We have also opened a new avenue of research about father involvement in family planning in the US.