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The study enrollments took place between August and July 2023. The intervention was carried out at the cluster level. The intervention was given by eight trained healthcare workers and supported by the theory of reasoned action and role model women who had the experiences of LARC utilization selected from community members. The three female and five male healthcare workers were trained for two days about the FP particularly LARC covering different topics including the definition of LARC, types of LARC, effectiveness, and duration. Also, its side effects, the myths, and misconceptions about LARC were covered during training. The health education protocol was adapted from the WHO guide to FP17, theory-based intervention for contraception 18, and theory of reasoned action approach to health promotion 19. The study participants were informed to participate in the study by health extension workers. The meeting was organized at their perspective cluster. The health education was provided two times within one month. One educational session lasted for fifty (50) minutes. Before the intervention, baseline data on socio-demographic factors, knowledge, attitudes, and LARC utilization were collected. The training modules included the key concepts of LARC, different types of LARC methods, the benefits and adverse effects of LARC, and myths and misconceptions regarding LARC. In addition, the interventional group received peer education from model women who had used LARC. These women described their personal experiences and the health benefits they obtained from using LARC. During the FP lecture, we discussed the various methods of FP, the possible side effects of each method, and the fear that some methods could lead to cancer. We also discussed complaints regarding the effectiveness of the methods. There were also several concerns raised regarding the approval of their husbands. Control group: The control groups did not receive the aforementioned interventions. However, they only received routine FP counseling in accordance with national FP guidelines, which consisted of a single two-hour educational session. Both interventional and control groups were followed for six months, which assumed that it would be sufficient time to bring change in health-seeking behavior. After six months, end-line data were collected using the same questionnaire as at baseline, except for the socio-demographic items, and assessed on their knowledge, attitudes, and utilization of LARC.

本研究的招募入组工作于2023年8月至7月开展。干预以整群为单位实施，由8名经过培训的医护人员执行，并得到合理行动理论（Theory of Reasoned Action）的支撑，同时依托从社区中遴选的、具有长效可逆避孕（Long-Acting Reversible Contraception，LARC）使用经验的女性榜样群体。其中3名女性、5名男性医护人员接受了为期2天的培训，培训内容聚焦计划生育（Family Planning，FP）尤其是LARC，涵盖LARC的定义、类型、有效性与持续时长，同时包括其不良反应、相关误区与误解等主题。本研究的健康教育方案改编自世界卫生组织（World Health Organization, WHO）FP17号计划生育指南、基于理论的避孕干预研究18以及基于合理行动理论的健康促进方法19。研究参与者由社区健康推广人员告知本研究招募信息，相关告知会议在各对应整群点组织开展。健康教育在1个月内分2次开展，单次教育时长为50分钟。干预实施前，研究人员收集了受试者社会人口学特征、知识水平、态度及LARC使用情况的基线数据。本次培训模块涵盖LARC核心概念、各类LARC避孕方法、其获益与不良反应、相关误区与误解等内容。此外，干预组还接受了曾使用LARC的榜样女性的同伴教育，这些女性分享了自身使用LARC的亲身经历及从中获得的健康益处。在FP讲座环节，我们探讨了各类避孕方法、每种方法的潜在不良反应，以及部分人群担忧部分避孕方法可能致癌的顾虑，同时还讨论了关于避孕方法有效性的相关质疑。此外，现场还提出了不少关于获得丈夫同意的顾虑。对照组：对照组未接受上述干预措施，仅按照国家计划生育指南接受常规FP咨询服务，即单次2小时的教育课程。干预组与对照组均被随访6个月，该时长被认为足以促使健康寻求行为发生改变。随访满6个月后，采用与基线调查一致的问卷（社会人口学问条除外）收集终末数据，评估受试者的LARC相关知识、态度及使用情况。