{"doi":"10.1111/bjhp.12713","title":"Effects of a community‐based, multi‐level family planning intervention on theoretically grounded intermediate outcomes for couples in rural Uganda: Results from a mixed methods pilot evaluation","abstract":"OBJECTIVES: This study tested the theoretically grounded conceptual model of a multi-level intervention, Family Health = Family Wealth (FH = FW), by examining FH = FW's effect on intermediate outcomes among couples in rural Uganda. FH = FW is grounded in the social-ecological model and the social psychological theory of transformative communication. DESIGN: A pilot quasi-experimental controlled trial. METHODS: Two matched clusters (communities) were randomly allocated to receive the FH = FW intervention or an attention/time-matched water, sanitation and hygiene intervention (N = 140, 35 couples per arm). Quantitative outcomes were collected through interviewer-administered questionnaires at baseline, 7-months and 10-months follow-up. Focus group discussions (n = 39) and semi-structured interviews (n = 27) were conducted with subsets of FH = FW participants after data collection. Generalized estimated equations tested intervention effects on quantitative outcomes, and qualitative data were analysed through thematic analysis-these data were mixed and are presented by level of the social-ecological model. RESULTS: The findings demonstrated an intervention effect on family planning determinants across social-ecological levels. Improved individual-level family planning knowledge, attitudes and intentions, and reduced inequitable gender attitudes, were observed in intervention versus comparator, corroborated by the qualitative findings. Interpersonal-level changes included improved communication, shared decision-making and equitable relationship dynamics. At the community level, FH = FW increased perceived acceptance of family planning among others (norms), and the qualitative findings highlighted how FH = FW's transformative communication approach reshaped definitions of a successful family to better align with family planning. CONCLUSIONS: This mixed methods pilot evaluation supports FH = FW's theoretically grounded conceptual model and ability to affect multi-level drivers of a high unmet need for family planning.","journal":"British Journal of Health Psychology","year":2024,"id":482971,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9535,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":966802,"name":"Christine Muhumuza","orcid":"0000-0002-3085-0116","position":1,"is_corresponding":false},{"id":330585,"name":"Rhoda K. Wanyenze","orcid":"0000-0001-5864-3314","position":2,"is_corresponding":false},{"id":251562,"name":"Trace Kershaw","orcid":"0000-0002-3300-1355","position":3,"is_corresponding":false},{"id":1324307,"name":"Brooke Ellerbe","orcid":null,"position":4,"is_corresponding":false},{"id":1324308,"name":"Suyapa Muñoz","orcid":null,"position":5,"is_corresponding":false},{"id":967208,"name":"Samuel Sekamatte","orcid":null,"position":6,"is_corresponding":false},{"id":947652,"name":"Haruna Lule","orcid":null,"position":7,"is_corresponding":false},{"id":422575,"name":"Susan M. Kiene","orcid":"0000-0001-8922-5289","position":8,"is_corresponding":false},{"id":947185,"name":"Katelyn M. Sileo","orcid":"0000-0003-3714-2945","position":0,"is_corresponding":true}],"reference_count":60,"raw_metadata":null,"created_at":"2026-07-19T02:07:22.248464Z","pmid":"38242837","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}