Researchers developed a questionnaire to examine seven provider issues identified as possible barriers to diaphragm use among APNs specializing in women’s health. They discussed the perceived degree to which each case represented a barrier. Non-parametric correlations were calculated between diaphragm fitting history, demographic and practice characteristics, and the response ratings for each issue.

They analyzed the responses for 204 APNs who averaged 15 years’ experience in women’s health care; 87% had fitted a diaphragm at least once, but 40% had not prescribed one in the past year. The degree to which each issue was a barrier varied. Based on respondents’ ratings of a ‘more than a moderate barrier,’ diaphragm non-promotion by women’s health providers, effectiveness doubts, unfamiliarity, and lack of access to educational materials were often perceived as impeding diaphragm use. APNs with recent diaphragm fitting history perceived five of the seven issues as less of a barrier.

The study concluded that the formulation of a successful strategy to reintroduce the diaphragm would depend on better identification and understanding of provider-perceived barriers. This paper offers new insights about barriers and guidance for the development of a system for diaphragm reintroduction.