Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Degree Program
Doctor of Nursing Practice
Degree Track
Post Master's DNP Completion
Year Degree Awarded
2019
DOI
https://doi.org/10.7275/14142180
Month Degree Awarded
May
Keywords
LARC, unintended pregnancy, contraception, barriers, long-acting reversible contraception, U. S. military women, family planning, access to primary care, RE-AIM
Advisor
Dr. Terrie Black
DNP Project Chair
Dr. Jacqueline Lamme
Abstract
Background: Unintended pregnancy in the United States (U.S.) is a significant health problem that takes on additional magnitude in the context of military service. Young, active duty women have higher unintended pregnancy rates compared to the general population, secondary to non-use of contraception or selection and use of the least effective methods (condoms and oral contraceptive pills). The literature validates the problem, identifies access barriers to highest-efficacy contraception options in primary care settings, and offers evidence-based, best practice opportunities to impact this public health challenge.
Purpose: The purpose of this project was to evaluate access, utilization, effectiveness, and patient satisfaction of the newly-implemented Walk-in Sexual Health (WiSH) clinic for contraception services delivery at a military health clinic in Okinawa, Japan.
Methods: The widely-used RE-AIM (Reach-Effectiveness-Adoption-Implementation-Maintenance) framework was employed to analyze the impacts of this health promotion initiative in the community. Data were collected to determine access to contraceptive clinic services, changes in high risk (age 18-24) female population use of long-acting reversible contraception (LARC), and baseline patient satisfaction, comparing 12-month periods, pre- and post-WiSH clinic implementation.
Results: LARC utilization increased among all demographic groups (women, age 18-53), but most substantially among populations of interest, namely high risk (18-24 years of age) active duty and non-active duty women. Patients reported very high baseline satisfaction with the clinic’s services.
Conclusion: The WiSH clinic eliminated known barriers to the most effective contraception options (LARC) and demonstrated its acceptance, utilization, and value in the community, according to the RE-AIM domains for health promotion.
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