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J Adv Nurs. 2016 Jul;72(7):1541-51. doi: 10.1111/jan.12931. Epub 2016 Mar 9.

A qualitative study of the barriers and enablers to fertility-awareness education in general practice.

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Department of General Practice, Monash University, Melbourne, Victoria, Australia.
School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia.
Centre for Research and Action in Public Health, University of Canberra, Australian Capital Territory, Australia.



To understand the barriers and enablers to fertility-awareness education in general practice.


Most women along with their primary care practitioners - general practitioners and practice nurses - believe that women should be educated about fertility-awareness when first reporting trouble conceiving. To date, no in-depth study has examined the enablers and challenges of this type of education in general practice.


A descriptive exploratory qualitative study using deductive content analysis.


General practitioners (N = 11) and practice nurses (N = 20) were recruited from general practices in three socioculturally diverse areas in Victoria, Australia. Data were collected through semistructured interviews based on the 12 domains of a theoretical behaviour change framework from April-August 2012. The participants' responses were organized into themes that fall under the framework domains.


The biggest barriers to fertility-awareness education in general practice were short consultations and time constraints faced by general practitioners together with a lack of patient educational materials and remuneration to support its delivery. The biggest enablers were a greater use of nurses trained in fertility-awareness in a collaborative team care arrangement with general practitioners.


This study has identified several important barriers and enablers to fertility-awareness education in general practice. Translation into practice of our findings is imperative as the first step in establishing a primary care model in fertility-awareness. This would fill an important gap in the primary care of infertile women and build capacity in general practice to reduce infertility through women's enhanced fertility knowledge.


family planning; fertility-awareness; general practice; infertility; midwifery; nursing; primary care

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