“We have to improve our culture about this”: Family planning decision-making among women and men living in Florence, Italy

The male condom is the most widely used family planning method in Italy and Southern Europe. Most family planning research is focused on women and, therefore, could be missing significant gender differences in behavior, as male partners play a critical role in decision-making and pregnancy prevention. This study aimed to explore attitudes toward contraceptive methods, including decision-making and desired improvements related to family planning in Italy. Semi- structured interviews with 42 men and women aged 18–50 years (29.1±7.9) living in or near Florence, Italy, were conducted between May and June 2019. Techniques from thematic analysis allowed for a constant comparative approach to contextualize data and identify emergent themes. HyperRESEARCH assisted in data management and analysis. Data resulted in three emerging themes: (1) Family planning decision-making dynamics; (2) Outside sources that influence family planning decision-making; and (3) Desired improvements to family planning. Participants engaged in most forms of family planning methods; however, participants also had knowledge gaps and misinformation about hormonal contraceptive methods' efficacy and long-term health effects. Participants clarified that family, general doctors, and other important persons (i.e., intimate partners) were the primary source of information about family planning methods. Findings offer practical recommendations to guide social marketing and behavior change interventions to increase family planning access among women and men in Italy. Improved messaging strategies could address concerns and knowledge gaps, improving family planning decision-making among couples.