Iowa Initiative Research Program: One stork, one state, and five studies

As part of the larger Iowa Initiative to Reduce Unintended Pregnancies, the Iowa Initiative Research Program is a set of five intervention studies designed to increase knowledge and to persuade adult women ages 18-30 to (1) seek and access contraception if they wish to delay or prevent pregnancy, and (2) improve contraceptive behaviors in this group. The program was a five year endeavor. The first year of the program was devoted to multi-method, formative research to provide the foundation for the individual projects that began in 2009 and continued through 2011. The intervention period is completed and evaluation is ongoing. One of the key outcome measures (unintended pregnancies among live births) has been measured annually for 20 years as part of another statewide assessment. The percentage of unintended pregnancies among live births has dropped in each intervention year of the program. Although the research designs do not allow for precise identification of causal factors, the evidence strongly suggests that the research interventions played a significant role in the multivariate constellation of influences lowering unintended pregnancy rates in the state. Details of the research program, challenges, and successes of a statewide public health effort will be discussed