Medicine and Health Sciences Commons^™

No More Baby Steps: Preventing Unintended Pregnancies Of Los Angles Minorities And Adolescents, Rachel Bass

Master's Projects and Capstones

Previous studies have identified pregnancy intention to correlate with both maternal and fetal health. Though unintended pregnancy rates are dropping in America, they remain high among minority and young women. Contraceptive usage, a leading protective factor for unintended pregnancies, has been found to vary greatly by age and ethnicity. These two projects aimed to decrease unintended pregnancy rates through increasing patient knowledge of contraceptive options and correct usage. The first project focused on creating a comprehensive, oral contraceptive pill instructional handout for research participants of the birth control pill study. This handout was created through the analysis of compliance errors …

A Qualitative Exploration Of Perceptions And Experiences Of Contraceptive Use, Abortion And Post-Abortion Family Planning Services (Pafp) In Three Provinces In China, Yan Che, Esther Dusabe-Richards, Shangchun Wu, Yi Jiang, Xiaojing Dong, Jian Li, Wei-Hong Zhang, Marleen Temmerman, Rachel Tolhurst, Inpac Group

Obstetrics and Gynaecology, East Africa

Background: The INPAC project aims to evaluate the effectiveness of integrated post-abortion family planning (PAFP) services into existing hospital based abortion services in China. A qualitative study was conducted in three provinces to contribute to developing effective PAFP services through understanding influences on contraceptive use, experiences of abortion and existing PAFP, and their effect on future contraceptive practices from the perspective of users, in the context of social and institutional change.

Methods: Twenty-nine in-depth interviews (IDIs) were undertaken with women who had experienced abortion between 1 and 6 months prior to interview, recruited from three urban and two rural facilities …

Pololeo Y Protección: Las Barreras De Acceso A Métodos Anticonceptivos Para Adolescentes Vulnerables En La Comuna De Macul, Santiago De Chile / Pololeo Y Protección: Barriers To Access Contraceptive Methods For Vulnerable Adolescents In The District Of Macul, Santiago De Chile, Louisa Boswell

Independent Study Project (ISP) Collection

El embarazo adolescente sigue siendo un problema de salud pública al nivel nacional en Chile. Aunque por ley, todos tienen el derecho a una educación sexual y a elegir un método de control de fecundidad, todavía existen casos de embarazos no planificados, particularmente entre adolescentes. Este estudio investigó las barreras que limitan el acceso a métodos anticonceptivos para adolescentes, enfocando primariamente en el sistema público en la Región Metropolitana. Específicamente, la investigación consideró las adolescentes de la comuna de Macul, utilizando muestras de un colegio local y dos centros de salud familiar para hacer conclusiones. La investigadora entrevistó a matronas …

Patient Centered Family Planning Care, Lauren Thaxton Md, Mba

Biomedical Sciences ETDs

The Institute of Medicine defines six important domains of health care quality: safety, efficacy, timeliness, efficiency, equitable delivery and patient-centeredness. Quality family planning care aims to provide individuals with the tools needed to engage in healthy and satisfying sex lives while planning and spacing pregnancies to achieve desired family size. The field of family planning strongly relies on the domain of patient-centeredness as individual values and preferences guide clinical care. Yet large gaps in knowledge exist in understanding how to improve patients’ clinical experience. This hybrid thesis posits avenues for improving the quality and patient-centeredness of clinical care.

Quality care …

Cost-Effectiveness Of A Family Planning Voucher Program In Rural Pakistan, Edward Ivor Broughton, Waqas Hameed, Xaher Gul, Shabnum Sarfraz, Imam Yar Baig, Monica Villanueva

Community Health Sciences

Introduction: This study reports on the effectiveness and efficiency from the program funder's perspective of the Suraj Social Franchise (SSF) voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016.
Method: A decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs) to targeted women, compared to business-as-usual. Costs included vouchers …

Inadequate Birth Spacing Is Perceived As Riskier Than All Family Planning Methods, Except Sterilization And Abortion, In A Qualitative Study Among Urban Nigerians, Hilary Schwandt, Joanna Skinner, Luciana Estelle Hebert, Lisa Cobb, Abdulmumin Saad, Mojisola Odeku

Fairhaven Faculty Publications

Background

Fertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians.

Methods

A total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four …

An Intravaginal Ring That Releases Three Antiviral Agents And A Contraceptive Blocks Shiv-Rt Infection, Reduces Hsv-2 Shedding, And Suppresses Hormonal Cycling In Rhesus Macaques, Nina Derby, Meropi Aravantinou, Jessica Kenney, Shweta R. Ugaonkar, Asa Wesenberg, Jolanta Wilk, Larisa Kizima, Aixa Rodriguez, Shimin Zhang, Olga Mizenina, Keith Levendosky, Michael L. Cooney, Samantha Seidor, Agegnehu Gettie, Brooke Grasperge, James Blanchard, Michael Piatak Jr., Jeffery D. Lifson, José Fernández-Romero, Thomas M. Zydowsky, Melissa Robbiani

Publications and Research

Women globally need access to multipurpose prevention technologies (MPTs) that prevent human immunodeficiency virus (HIV), sexually transmitted infections that increase HIV acquisition/transmission risk, and unintended pregnancy. Seeking an MPTwith activity against HIV, herpes simplex virus-2 (HSV-2), and human papillomavirus (HPV), we developed a prototype intravaginal ring (IVR), the MZCL IVR, which released the antiviral agents MIV-150, zinc acetate, and carrageenan (MZC for short) and the contraceptive levonorgestrel (LNG). Previously, we showed that an MZC gel has potent activity against immunodeficiency viruses, HSV-2, and HPVand that the MZCL (MZC with LNG) IVR releases all four components in macaques in vivo at …

Promoting Reproductive Health Using Telemedicine: A Prospective Study Among Rural Appalachian High School Teens, Raj Singh, Mohit Harsh, Keegan Mullins, Brian Dunlap, Jennie L. Yoost

Brian Dunlap

Introduction: Telemedicine allows rural underserved populations access to medical resources that may not be available in their communities. Following promising results with a telemedicine project aimed at educating female students in McDowell County, West Virginia on reproductive health (RH) in 2015, we conducted a follow-up study including both male and female high school students during the 2016 school year. Materials and Methods: Telemedicine sessions on RH were incorporated into existing afterschool programs at two rural high schools. Students’ knowledge on RH was assessed via pre-test, immediate post-test, and 6-month post-test evaluations. RH was taught by medical students and faculty at …

Contraceptive Counseling Practices Among Providers Prescribing Opiates To Women Of Childbearing Age, Lucy A. Iselborn

Honors College

Opiate use has reached epidemic levels in the United States, resulting in 28,647 deaths in 2014 alone. Prenatally, opioids are used for both pain management and to assist with opiate dependency. The level of risk associated with the use of opiates is much higher for pregnant women, and women of childbearing age, due to the detrimental effects opiates have on the developing fetus including, neonatal abstinence syndrome (NAS). Maine is leading the nation in the number of NAS births with incidence rates of greater than 30 per 1,000 hospital births. Pregnancy prevention is an upstream approach to reduce unintended pregnancy …

Promoting Reproductive Health Using Telemedicine: A Prospective Study Among Rural Appalachian High School Teens, Raj Singh, Mohit Harsh, Keegan Mullins, Brian Dunlap, Jennie L. Yoost

Marshall Journal of Medicine

Introduction:

Telemedicine allows rural underserved populations access to medical resources that may not be available in their communities. Following promising results with a telemedicine project aimed at educating female students in McDowell County, West Virginia on reproductive health (RH) in 2015, we conducted a follow-up study including both male and female high school students during the 2016 school year.

Materials and Methods:

Telemedicine sessions on RH were incorporated into existing afterschool programs at two rural high schools. Students’ knowledge on RH was assessed via pre-test, immediate post-test, and 6-month post-test evaluations. RH was taught by medical students and faculty at …

Family Planning Dynamics In Zimbabwe, Heidi Weidele

Senior Honors Projects

Almost 90 percent of all women in Zimbabwe lack health insurance. Most are undereducated or underemployed, and only have access to maternal and contraceptive care via public clinics. There is a large gap in family planning services in both rural and urban areas, which leads to a lack of necessary care in many communities. Bivariate and multivariate analyses on demographic data (Zimbabwe Demographic and Health Survey 2015) collected by the Zimbabwe National Statistics Agency and compiled by the United States Demographic and Health Surveys Program were performed to determine the relationships among public health services and female demographics (including education, …

Promoting Teen Contraceptive Use By Intervention With Their Mothers, Richard A. Crosby, Tom Collins, Lindsay R. Stradtman

Health, Behavior & Society Faculty Publications

Introduction: The purpose of this pilot study was to test a community outreach model designed to help mothers in a rural, medically underserved area navigate their teen daughters to health department services for long-acting reversible contraception (LARC) or alternative contraception.

Methods: The pilot study used a single-group, post-test only design. Mothers of teen daughters (N=142) received a 1-hour, one-to-one intervention session (in outreach settings) from Community Liaisons. Mothers received training on how to communicate with their daughters about LARC and other contraceptive methods. Data were collected from June through October 2014, and analyzed in September 2015.

Results: The authors re-contacted …

The Effects Of Asking A Fertility Intention Question In Primary Care Settings: A Systematic Review Protocol, Paul A. Henning, Carolyne K. Burgess, Heidi E. Jones, Wendy V. Norman

Publications and Research

Background: Planning for pregnancy has been associated with reduced unwanted pregnancies and improved pregnancy outcomes. Despite the benefits of planned pregnancy, there are no guideline recommendations on routine counseling regarding pregnancy intention in primary care settings. The objective of the systematic review is to determine the effectiveness of incorporating questions of pregnancy intention into primary care.

Methods: A systematic search of the literature will be conducted for any studies comparing questions of pregnancy intention in primary care settings with no intervention or a control intervention. Types of studies will include randomized controlled trials, non-randomized trials, and observation studies. Participants …

Implementation Of Family Planning And Contraception For Female Inmates In Vermont, Callan Janowiec Fnp

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background and Objective(s): Unplanned pregnancies are disproportionately high among female inmates, and incarceration provides a unique opportunity for care may be otherwise difficult to obtain, including reproductive health and family planning services, specifically the provision of contraception. It is known that women are 14 times more likely to initiate contraception if education and services are provided within the prison (Clarke et al., 2006b). Despite decades of research identifying the unmet need, very few prisons around the country provide any sort of sexual health or family planning care to prisoners (Braithwaite, Treadwell, & Arriola, 2008).

Methods: This project involves the creation …

Contraceptive Service Provider Imposed Restrictions To Contraceptive Access In Urban Nigeria, Hilary Schwandt, Ilene S. Speizer, Meghan Corroon

Fairhaven Faculty Publications

Background: Health service providers can restrict access to contraceptives through their own imposed biases about method appropriateness. In this study, provider biases toward contraceptive service provision among urban Nigerian providers was assessed.

Methods: Health providers working in health facilities, as well as pharmacists and patent medical vendors (PMV), in Abuja, Benin City, Ibadan, Ilorin, Kaduna, and Zaria, were surveyed in 2011 concerning their self-reported biases in service provision based on age, parity, and marital status.

Results: Minimum age bias was the most common bias while minimum parity was the least common bias reported by providers. Condoms were …

Family Planning Practices Of Rural Community Dwellers In Cross River State, Nigeria., A. J. Etokidem, W. Ndifon, Ekaete Asuquo, J. Etowa

School of Nursing & Midwifery, East Africa

Background: Nigeria is the most populous nation in Africa and the seventh most populous in the world. Despite a high fertility rate of 5.5 per woman and a high population growth rate of 3.2%, Nigeria’s contraceptive prevalence is 15%, which is one of the lowest in the world. The objective of this study was to determine the knowledge of family planning and family planning preferences and practices of rural community women in Cross River State of Nigeria.

Materials and Methods: This was a cross-sectional study involving 291 rural women. Convenience sampling method was used. The women were assembled in a …

Effectiveness Of A Natural Family Planning Service Program, Richard Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

Purpose: The aims of this study were to determine and compare extended use-effectiveness of an online nurse-managed fertility education service program among women (and subgroups of women) seeking to avoid pregnancy.

Study Design and Methods: This was a 24-month prospective study of a university-based online Web site with 663 nonbreastfeeding women using an online charting system to avoid pregnancy. Participants tracked their fertility online with either cervical mucus monitoring, electronic hormonal fertility monitoring, or both fertility indicators. Unintended pregnancies were validated by professional nurses.

Results: Participants had a mean age of 30.4 years (SD = 6.3) and mean 1.7 children …