Medicine and Health Sciences Commons^™

Over-The-Counter Approval Of Progestin-Only Pills, Hannah Grace Donovan

Family Medicine Clerkship Student Projects

Most women in the United States use contraception at some point in their life. While there are many types of short- and long-acting reversible birth control options available via prescription, the oral contraceptive pill (OCP) remains the most used reversible contraceptive agent. The proportion of those using an OCP is inversely proportional with age; more specifically, people who can get pregnant between the ages of 15 and 29 use OCPs most frequently. However, people in this age range may face increased barriers to obtaining contraception, such as cost, insurance, social and familial factors, policy, transportation, and access to healthcare. In …

Contraceptive Education And Resource Provision In Male-Dominated Rural Family Medicine Clinic, Christine E. Horn

Family Medicine Clerkship Student Projects

Many women, particularly adolescent women, are uncomfortable discussing sexual health and contraception options with male providers and prefer to see female providers; however, in rural areas, there are barriers to seeing female providers including low physician density, long travel distances to clinics, and long waitlists. The project's primary goal was to bridge the knowledge gap surrounding contraception among adolescents in a rural area of Vermont, the Mad River Valley, while ensuring that healthcare providers at the local male-dominated family medicine office, CVMC Mad River, are equipped with up-to-date information regarding contraception prescribing recommendations. The project entailed 1) creation of a …

Improving Knowledge Of Contraceptive Options In Teenage Male Populations, Anthony Quach

Family Medicine Clerkship Student Projects

Despite a plethora of contraception available on the market, nearly 50% of pregnancies in Vermont are unintended. Currently, most educational initiatives aimed at improving contraceptive usage are targeted towards individuals with uteruses, and not their partners with penises. Both qualitative and quantitative data suggest that there are significant gaps in this latter population’s knowledge about contraception for various reasons like limited contraceptive education within formal sexual education in schools, lack of parental and/or physician discussions about contraception, and various complex social and cultural factors. This intervention aims to bridge the knowledge gap in this population by using an educational pamphlet. …

Evaluation Of Clinician Prescribing Practices For Contraceptive Care: A Quality Improvement Collaboration, Julie Desrochers

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

Purpose: Primary care providers (PCPs) have the training and opportunity to provide contraceptive care. Unplanned pregnancy is a major public health issue for which up to 50% of the population is at overall lifetime risk. Reproductive life planning during healthcare visits can reduce rates of unintended pregnancy, prompting contraception or preconception planning. Studies suggest contraceptive counseling protocols and reproductive intent screening are effective tools. This project compares clinician behaviors with best practices. The purpose is to evaluate preventive reproductive healthcare practices in primary care, identifying opportunities to meet the contraceptive healthcare needs for people of reproductive age.

Methods: PCPs and …

Improving Contraception Among Female Syringe Exchange Clients: A Reproductive Needs Assessment, Gena Zollman

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

Purpose: Women with opioid and other substance use disorders have a high rate of unintended pregnancy and a low rate of effective contraceptive use. Integrating family planning (FP) services into medication-assisted treatment (MAT) clinics has increased rates of initiation and adherence to contraception among this population. This study assesses the reproductive health needs of female clients in a syringe exchange program (SEP)to assess if integrating FP services would improve access to contraception.

Methods: Female clients of a SEP voluntarily completed an anonymous survey to determine demographics, FP needs, and barriers to accessing care, and were compensated with $20 gift cards. …

Assessing Need And Resources For Providing On-Site Access To Long Acting Reversible Contraceptives In University Student Health Setting, Madeline Howe

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

Purpose. Over 50% of all pregnancies in the state of Vermont are unintended, despite the availability of effective contraceptive methods. Long-acting reversible contraceptives (LARCs), including intrauterine contraceptive devices and implantable contraceptive devices, are the most effective form of reversible contraception. However, they make up a minority of contraceptive use. Studies have established that women overwhelmingly choose LARCs when educated about their efficacy, cost, and convenience.

Methods. A needs assessment was conducted using data query of electronic health records and informal interviews with Student Health Services (SHS) providers and administrators at a northern New England university. Suppliers and insurers were contacted …

Patient Education On The Association Of Hormonal Contraception With Depression, Julia E. Hannigan

Family Medicine Clerkship Student Projects

Hormonal contraceptive agents are widely used by women during their reproductive years. In recent years, research has been released linking hormonal contraception with the initiation of antidepressant medication and a first diagnosis of depression. More research is still warranted in order to further elucidate the relationship between hormonal contraception and depression, but current evidence prompts the necessity for shared decision making between clinicians and women considering treatment with hormonal contraceptive agents. The goal of this project is to give providers easily accessible patient educational materials in the form of epic smart phrases to aid in informed decision making.

Contraception Health Notes At Brookfield Family Practice, Nana Agyepong

Family Medicine Clerkship Student Projects

The Brookfield Family Practice office sees a variety of patients, including women that are of reproductive age. The topic of contraception and contraception choices is always very relevant. My preceptor makes all of his own patient education handouts and expressed the need for an up to date handout on contraception choices for his own use and for the practice in general.

Postpartum Contraception Education, Erin E. Hunt

Family Medicine Clerkship Student Projects

The current standard of practice for postpartum contraception in Plattsburgh, NY, as well as much of the United States, is initiation of contraception at the standard 6 week postpartum visit. However, many women may be better suited for immediate postpartum contraception while still hospitalized in labor and delivery. Long acting reversible birth control (LARC), including hormonal IUDs, copper IUDs, and progesterone implants, were the contraception types focused on in this project. Family medicine residents at CVPH reported low confidence in postpartum contraception as a whole. Furthermore, they reported limited knowledge on immediate postpartum contraception. The primary aim of this project …

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 …

Patient Awareness And Understanding Of Intrauterine Devices, Lindsey Marie Eastman

Family Medicine Clerkship Student Projects

Unintended pregnancy rates in the United States are near 50%, but use of safe and effective long-acting reversible contraception methods, such as intrauterine devices, remain low compared to worldwide rates. Common misconceptions about intrauterine devices likely contribute to this stark contrast in use prevalence. This project aimed to assess patient understanding, awareness, and perception of intrauterine devices at a Family Medicine office in Connecticut. A pamphlet that includes a summary of contraception methods was produced and distributed with the goal of increasing knowledge of intrauterine devices as well as other contraception methods for patients in the primary care setting.

Long-Acting Reversible Contraceptives In Vermont: A Survey Based Assessment Of Current Knowledge Of Providers Of Women Of Reproductive Age, Erin O'Brien

Graduate College Dissertations and Theses

Unintended pregnancies are a long-standing public health issue nationally, with percentages hovering around 50% for at least the last five years. Vermont is doing slightly better than the national average, but is faced with it's own challenges due to it's rural nature. Agencies and organizations, such as the World Health Organization, March of Dimes and the Vermont Department of Health have made decreasing unintended pregnancies one of their priorities to improve maternal and fetal health outcomes, as well as social and economic opportunities for families. Current evidence-based guidelines call for long- acting reversible contraceptives (LARCs), including intrauterine devices (IUDs) and …