Date of Award
2025
Document Type
Doctor of Nursing Practice (DNP)
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chair
Darlene Showalter
Committee Member
Michael K. Johnson
Subject(s)
Minority women, Contraception, Counseling, Health self-care, Communication in medicine
Abstract
Initiating a Contraception Protocol at a North Alabama Historically Black College and University (HBCU) Background: Nearly half of pregnancies in the U.S. are unplanned; higher in adolescents, lower income, minority, and single women with poverty rates already twice that of other groups. For black women, the unintended pregnancy rate is disproportionately high in comparison to their white counterparts. These pregnancies promote a significant risk of morbidity and mortality. Black women face barriers associated with inadequate access to reliable and affordable contraception, stereotyping, racial bias, and lack of resource information. These barriers can result in health disparities with a devastating impact on personal and perinatal outcomes. Purpose Statement: To implement a protocol at a college clinic to screen for contraception status and initiate discussions with all female patients on contraceptives promoting uptake PICOT: At a student health clinic, does implementation of a contraceptive screening protocol, compared with no protocol, result in increased contraception discussions and uptake? Methods: The Self-Identified Need for Contraception (SINC) screening algorithm was implemented beginning with, “Would you like to speak with your provider about contraceptives today?”. If yes, a tablet with the electronic educational tool My Birth Control was provided with a comprehensive review of contraceptives in preparation for a discussion with the provider. Shared decision-making was employed to ensure that options were clinically relevant and meaningful to the patient. Contraceptives, prescriptions, and referrals were provided as warranted. A text was sent out two weeks later to assess uptake. Results: 454 women were asked the SINC question. 416 (91.6%) declined the discussion. Reasons: 45% were already on contraception, 33.2% said they were there for another reason, 15.9% did not want contraception, 5.3% said the question did not apply to them, 0.7% were trying to get pregnant, and the rest indicated they were not sexually active 4.56%. Thirty-eight women (8.4%) did agree to the discussion and received education, and 34 (89.5%) initiated contraception. Conclusion/Nursing Implications: Contraception remains a critical topic of discussion and decision. Declining to discuss the subject serves as an obstacle to education and uptake. Methods that ensure a safe environment for the educational discussion should continue to be explored, as women who engage in unprotected sexual practices are at risk of unplanned pregnancies and compromised perinatal outcomes.
Recommended Citation
Dickerson, Rebecca, "Initiating a contraception protocol on a North Alabama Historically Black College and University" (2025). Doctor of Nursing Practice (DNP). 150.
https://louis.uah.edu/uah-dnp/150