In a participatory action research program called Photovoice, Hispanic immigrants in a Midwestern community took photographs to provide researchers with insight regarding family planning. This report describes the Photovoice approach, why the researchers chose it, how they implemented it, what they learned, and the benefits derived for a larger service project.

In an effort to discover what can improve family planning services for recently immigrated Hispanic women and to foster cultural competence among health care providers in this arena, the authors conducted four focus groups of recently immigrated Hispanic women in a mediumsized Midwestern community. The focus group discussions covered such topics as health care, knowledge of birth control, domestic life, and economic issues in the United States. The participants demonstrated knowledge of and support for the concept of family planning and specific birth control methods. They also identified issues that challenge the use of birth control at the individual, family, system, and cultural levels.

CONTEXT: Although research has examined providers' knowledge, attitudes and prescribing behaviors with regard to emergency contraception, none has used a theory-based approach to understanding the interplay of these factors. METHODS:A cross-sectional survey of 96 faculty physicians from one Southern and three Midwestern universities was conducted in 2004 to assess factors associated with intention to prescribe emergency contraception. The theory of reasoned action guided the study hypotheses and survey design. Correlation and regression analyses were used to examine the data. RESULTS:Only 42% of respondents strongly intended to prescribe emergency contraception for teenagers, but 65-77% intended to do so for all other specified groups (women who ask for the method, who have had a method problem, who have experienced rape or incest, and who have had unprotected sex). Consistent with the theory of reasoned action, high intention to prescribe emergency contraception was associated with positive attitudes toward doing so and with the perception that specific colleagues or professional groups support prescribing it; however, the perception of support by colleagues or professional groups in general did not predict intention. Also consistent with the theory, physicians' knowledge about emergency contraception and their demographic characteristics were not significant. CONCLUSIONS:Interventions to encourage physicians to provide emergency contraception should take into account their attitudes toward the method and the components of those attitudes.

<h4></h4> <p>The relationship between pregnancy intention (unintended versus intended pregnancy) and social well-being was examined in a sample of 72 pregnant, mostly low-income women attending Women, Infants, and Children programs and prenatal clinics in a midwestern community. Feelings of happiness about giving birth and the extent to which having a baby would fill a void in one&rsquo;s life were also examined. Pregnancy intention was significantly associated with reduced social support. Feelings of happiness about having the baby positively correlated with all domains of social support and negatively correlated with loneliness and family relationship problems. The belief that having a baby could fill a void in a woman&rsquo;s life was strongly correlated with perceived loneliness. Interventions to increase social support and to address areas of stress for women whose pregnancies are unintended are recommended. Future research in larger random samples is needed to better test these associations and to make recommendations for specific practice interventions to increase social well-being.</p> <h4></h4> <p>Dr. Sable is Associate Professor and Interim Director, School of Social Work, University of Missouri-Columbia, Columbia, Missouri; Ms. Washington is a graduate student, University of Washington, Seattle, Washington; Ms. Schwartz is Assistant Director of Foundation Relations, University of Missouri-Columbia, Columbia, Missouri; and Ms. Jorgenson is Therapist and Case Manager, Boys and Girls Town of Missouri, Columbia, Missouri. At the time this article was written, all authors were at the School of Social Work, University of Missouri-Columbia.</p> <p>The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. This research was funded in part by the McNair Scholars Program at the University of Missouri-Columbia. </p> <p>Address correspondence to Marjorie R. Sable, DrPH, MSW, Associate Professor and Interim Director, School of Social Work, University of Missouri-Columbia, 730 Clark Hall, Columbia, MO 65211-4470; e-mail: <a href="mailto:SableM@missouri.edu">SableM@missouri.edu</a>.</p>

Interventions to encourage physicians to provide emergency contraception should take into account their attitudes toward the method and the components of those attitudes.