Urologists perform the majority of vasectomies in the United States; however, family medicine physicians (FMPs) perform up to 35%. We hypothesized that differences exist in practice patterns and outcomes between urologists and FMPs. Patients who underwent a vasectomy from 2010 to 2016 were identified. Postvasectomy semen analysis (PVSA) practices were compared between urologists and FMPs, before and after release of the 2012 AUA vasectomy guidelines. From 2010 to 2016, FMPs performed 1435 (35.1%) of all vasectomies. PVSA follow-up rates were similar between the two groups (63.4% vs 64.8%, P = 0.18). Of the patients with follow-up, the median number of PVSAs obtained was 1 (range 1-6) in both groups (P = 0.22). Following the release of guidelines, fewer urologists obtained multiple PVSAs (69.8% vs 28.9% pre- and post-2012, P < 0.01). FMPs had a significant but lesser change in the use of multiple PVSAs (47.5% vs 38.4%, P < 0.01). Both groups made appropriate changes in the timing of the first PVSA, but FMPs continued to obtain PVSAs before 8 weeks (15.0% vs 6.5%, P < 0.01). FMPs had a higher rate of positive results in PVSAs obtained after 8 weeks, the earliest recommended by the AUA guidelines (4.1% vs 1.3%, P < 0.01). Significant differences in PVSA utilization between FMPs and urologists were identified and were impacted by the release of AUA guidelines in 2012. In summary, FMPs obtained multiple PVSAs more frequently and continued to obtain PVSAs prior to the 8-week recommendation, suggesting less penetration of AUA guidelines to nonurology specialties. Furthermore, FMPs had more positive results on PVSAs obtained within the recommended window.
Adult ; Humans ; Male ; Physicians, Family/statistics & numerical data* ; Practice Patterns, Physicians'/statistics & numerical data* ; Retrospective Studies ; Urologists/statistics & numerical data* ; Vasectomy/statistics & numerical data* ; Wisconsin

The use of communication media suitable for the audience and message is important in conducting effective family planning IEC activities. This study 'intended to assess differential effects of various media used by the Korean program on rural women's family planning knowledge, attitude, and practice. Data for the study were collected originally for the study of family planning mothers' clubs by the School of Public Health, Seoul National University in 1973. The sample was drawn according to the principle usually employed in obtaining a small sample from a large area. Initially, a sample of 25 Gun's was selected from a total of 138 Gun's by systematic random sampling on the basis of the list of number of mother's clubs in each Gun. Secondly, from each of these primary units(Gun) selected, two second stage units(Myon) were drawn by a systematic random sampling method based on the list of the number of Li's -in each Myon. Finally, a sample of nine Li's was drawn by a simple random sampling method from each Myon selected in the second stage sampling. In this way, a total of 450 Li's, 18 Li's from each of 25 Gun's, were selected. In one of thess 18 Li's of each Gun, all the married women with a living husband, up to age 49, were interviewed. out of 1.052 women interviewed, 145 women were naturally sterile or beyond menopause, and were excluded from thib study. Thus, the analytical population consists of 90 fecundable wives, including those with tubal ligation. A series of analyses were made to examine the relationships between family planning status and selected socio-demographic and communication variables. The family planning status was measured by three indicators, one for each of family planning knowledge, attitude, and practice. The variable for family planning knowledge was created by classifying the respondents into two groups: 1) those who professed to know in detail at least one contraceptive method out of a total of five, including the loop, oral pill, vasectomy, condom, and rhythm, and 2) those who had no professed knowledge about any method. The variable for family planning attitude was dichotomized into those who had favorable attitude toward at least one method among the same list of five, and those who did not have a favorable attitude toward any method. Contraceptive status was classified into two categories of current users and non-users. The independent variables, applied to explain the family planning status, include four sociode-mographie variables and six communication variables. The socio-demographic variables are age, education, number of living children and sons, and ideal number of sons. Communication variables are frequency of exposure to family planning messages through each of the following channels: radio and/or TV, newspaper and/or magazine, 'Happy Home' and/or leaflet, public meeting and/or lecture, family planning worker, and neighbor. Major findings obtained from the analysis are summarized as follows: 1. It was observed that about 33% of the eligible women did not want to have additional children but were not practicing contraception(pong-eem). About half of these women were ever-users and the other half were never-users. They have at least perceived the need for family planning, and thus, should be a primary target population for family planning IEC activities. 2. Socio-demographic variables showed a'closer association with practice than with knowledge or attitude. 3. The communication variables affected family planning status over and above the effects of the socio-demographic variables. When the communication variables were added to the socio-demographic variables as independent variables in the multiple classification analysis, the explained variance was increased by 6.3% in knowledge, 8.7% in attitude, and 4.3% in practice. This also suggests that the communication variables exert larger effects on knowledge and attitude than on practice. Family planning adoption decisions may be influenced by many other factors as well as by family planning knowledge and attitude. 4. The Beta-coefficient was computed for each of the independent variables in multiple classification analysis. Among the media considered in this study, 1) neighborhood communication, radio and/or TV, and 'Happy Home' and/or leaflet had significant effect on family planning knowledge:2) public meetings and/or lecture, radio and/or TV, and neighborhood communication had significant effect on family planning attitude: and 3) radio and/or TV, Happy Home and/or leaflet, and home visit had significant effect on family planning practice. Although program media, neighborhood communication, and radio and/or TV appeared to be more effective than other media, no definite pattern emerged. In the interpretation of these data, however, it should be remembered tha t the frequency of contact varies with the media. 5. When women were exposed to family planning messages more frequently, they tended to have more detailed knowledge about, and more favorable attitudes toward family planning, and were more likely to he practicing family planning. 6. Media behavior differed with age and educational level. It was found that the younger the women and the higher their educational level, the more frequently they were exposed to family planning messages through radio, TV, or printed materials. On the other hand, the older the women and the lower their educational level, the more frequently they were exposed to family planning messages through meetings, home visits, and neighborhood communication. This implies that the audiences' characteristics, such as age and educational level, should be taken into account in the selection of appropriate media.
Child ; Condoms ; Contraception ; Surveys and Questionnaires ; Education ; Family Planning Services* ; Female ; Hand ; Health Services Needs and Demand ; House Calls ; Humans ; Menopause ; Mothers ; Newspapers ; Periodicals as Topic ; Public Health ; Residence Characteristics ; Seoul ; Spouses ; Statistics as Topic ; Sterilization, Tubal ; Vasectomy ; Periodicals

1. Instruction. Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project on order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was meeded. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myum. 2. Survey Method. An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing technique for three days. The team consisted of a public health nurse, four nurse-aides, a asnitarian and four health extension workers who are working in our project. The survey was carried out during the period November 1971 to March 1972. 3. Project area. 1) Population of Soyang-Myum was 11,668 ; male, 5,962 and female, 5,706. Sex ratio : 104.5. 2) Households : 1,858. 3) Family size : The average household consisted of 6.3 persons. 4) Education level of householder. a. Illiterate 13%. b. No schooling but able to read 10%. c. Preschool Children 19%. d. Primary School 47%. e. Middle School 7%. f. High School 3%. g. College or University 1%. 5) Occupational distribution of householders. a. Farmer 67%. b. Laborer 13%. c. Office worker 4%. d. Merchant 4%. e. Industrial worker 2%, f. Unemployed 8%, g. Miscellaneous 2%, 6) Religious affiliation. a. No religion 74%, b. Buddhist 12%, c. Protestant 10%, d. Catholic 4%. 4. Survey results. Living Environment : a. Home ownership 95%, b. Kinds of roofing. Straw-thatched house 84%, Tile-roofed house 10%, Slate-roofed house 5%, Other 1%. c. Floor space, Less than 6 pyong 10%, 6-10 pyong 53%, 1-15 pyong 24%, 16-20 pyong 9%, More than 20 pyong 4%, d. Radio ownership 80%. Environment : a. the source of drinking water. public well 49%, private well 30%, drainage water 9%, steam water 8%, well pump 3%, water distribution system 1%, b. Distance between well and toilet. more than 16 meter 38%, 6-10 meter 31%, 11-15 meter 14%, Less than 6 meter 17%. c. The status of well management. Bad 72%, Fair 26%, Good 12%. d. General sanitary of well management. Bad 37%, Fair 51%, Good 12%. e. House drainage system. had no house drainage 77%. Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods. loop 68%, oral pill 16%, vasectomy 4%, condom 1%, tubal ligation 1%, two or more methods 10%. Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26%, 6 times 11%, 5 times 11%, 4 times 9%. b. The place of delivery. own house 88%, hospital 1%, others 11%, Treatment of general sickness. a. The place of treatment, Soyang Health Center 31%, Hospital(Private or otherwise) 26%, Pharmacy 14%, Herb medicine 5%, Private care 5%, No treatment 12%, Miscellancous 7%. b. Usual causes of disease. Unknown 46%, Tuberculosis 29%, Neuralgia 8%, CVA 3%, Bronchitis 3%, Others 11%.
Bronchitis ; Child, Preschool ; Community Health Services ; Community Medicine ; Condoms ; Contraceptive Agents ; Surveys and Questionnaires ; Drainage ; Drinking Water ; Education ; Family Characteristics ; Family Planning Services ; Female ; Fertilization ; Health Surveys* ; Humans ; Male ; Maternal Health ; Neuralgia ; Nurses, Public Health ; Ownership ; Pharmacy ; Protestantism ; Sanitation ; Sex Ratio ; Steam ; Sterilization, Tubal ; Tuberculosis ; Vasectomy ; Vital Statistics ; Water