Counseling Women About Reproductive Health

DNP: PICO Introduction
Information is power in healthcare. This is particularly true in the area of contraception, given that a great deal of misinformation exists in the popular culture and online in relation to women’s sexual health. It is thus vitally important to know how best to teach women about how best to manage their reproductive lives so that they have the maximum amount of autonomy over when and with whom they have children. According to Dehlendorf, Krajewski, & Borrero (2014), the rate of unintended pregnancy is 50% in the United States, a rather extraordinary figure given the status of the nation as one of the world’s most developed nations. My PICO question for my DNP project is: “In childbearing women who receive GYN services at an OB/GYN clinic (P), how effective is a structured contraception counseling (I) compared to the current individual teaching sessions (C) offered by the healthcare provider in increasing patients’ knowledge of contraception (O)?”
My question is specifically designed to answer the question of how best to disseminate healthcare-related information to patients. It is based upon the principle that “providers have the potential to positively influence women's ability to use contraception during health care visits…Optimizing this counseling is one approach to helping women of all race/ethnicities and socioeconomic strata to improve their ability to plan pregnancies” (Dehlendorf, Krajewski, & Borrero, 2014, par. 3). Healthcare providers have both authority and the attention of the patient, making these encounters critical in the promotion of accurate information (versus information on social media or disseminated by peers). The DNP project will use a literature review to determine critical success factors that have enhanced previous structured contraceptive counseling and then use an experimental and control group to determine which approach was more effective in facilitating patients’ ability to achieve their goals regarding their current contraceptive use and also their assessed level of knowledge about contraceptives in general before and after counseling.
Thus far, I have worked on sections 1, 2, 3, and 7 based on the DNP Project guideline. I have an overview of the general problem and model and have begun to explore different theoretical models to support the dissemination of the knowledge conveyed within the framework of the project. The Health Belief Model “is a cognitive, interpersonal framework that views humans as rational beings who use a multidimensional approach to decision-making regarding whether to perform a health behavior” (Hall, 2012, par. 12). The HBM views knowledge as empowering for patients and suggests that if patients have sufficient knowledge at their disposal, they will be able to use it in an effective fashion.
The HBM specifically targets assumptions the patient may initially have that may be in error, spanning from the idea that unplanned pregnancy at a young age may be beneficial to inaccurate beliefs about reproduction, such as the idea that it is impossible to become pregnant the first time one has intercourse. It then provides contraceptive and counseling specifically designed to address inaccurate beliefs. The goals for the practicum will include refining the HBM model to create a more specific and structured program to advance the knowledge of the target audience. Further refinement of the target audience is necessary, so that the counseling program can more accurately match the level of health literacy and the needs of the target demographic making use of these counseling programs. The program will then be compared against the current framework used at the clinic and an experimental and a control group will be used to test the hypothesis regarding the superiority of the new program.


References
Dehlendorf, C., Krajewski, C., & Borrero, S. (2014). Contraceptive counseling: Best practices to
ensure quality communication and enable effective contraceptive use. Clinical Obstetrics and Gynecology, 57(4), 659–673. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216627/
Hall, K. S. (2012). The Health Belief Model can guide modern contraceptive behavior research
and practice. Journal of Midwifery & Women’s Health, 57(1), 74–81.
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790325/