Doctor of Nursing Practice (DNP) Projects

Access Control

Open Access

Embargo Period


Degree Program

Doctor of Nursing Practice

Degree Track

Post Master's DNP Completion

Year Degree Awarded


Month Degree Awarded



LARC, unintended pregnancy, contraception, barriers, long-acting reversible contraception, U. S. military women, family planning, access to primary care, RE-AIM


Dr. Terrie Black

DNP Project Chair

Dr. Jacqueline Lamme


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.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.