Contraception Education in Primary Care: Addressing Education Deficits in Rural Oregon

Abstract

Purpose: This quality improvement project explored educating patients of childbearing age in a rural Oregon medical clinic about different contraception available to them when considering pregnancy prevention. Background: The United States still currently has higher rates of unintended pregnancy when compared to other industrialized counties. Many times, unintended pregnancy rates are not due to lack of access to contraception, but rather factors including incorrect use, cost, providers comfort with contraception, as well as lack of education. The most effective form of contraception is long-acting reversible contraception including the IUD and implant. While most effective, many times in rural communities due to myths, lack of education, and lack of access by patients it is difficult to implement. Methods: The Institute for Healthcare Improvement Model for Improvement model was utilized to frame this quality improvement project with a plan-do-study-act strategy to help implement. Key stakeholders helped identify patients who agreed to participate. Each participant was asked pre-education questions, watched an educational video on contraception, provided with an educational handout, and then participated in a post-education survey. Questions measured their comfort with different contraception methods and myths regarding long-acting reversible contraception. Results: Data was collected over a 10-day period, resulting in twelve participants. When assessing for openness to attempt other contraception methods, the posttest survey concluded that except for a few methods women were more open to other forms of contraception. Women were willing to try long-acting reversible contraception such as the IUD. Participants increased their perceived education of long-acting reversible contraception on a scale of 0-10 by 2.3 points, their perception of safety 1 point, and perception of side effects 2.3 points. Overall, 100% of participants believed that this education increased their awareness and openness to other contraception methods. Conclusions: Despite the known benefit of education to patients on all contraception methods as well as more specifically long-acting reversible contraception, a lack of knowledge was identified in this patient population. In rural health, primary care practitioners are many times the main provider of healthcare to women and are uniquely positioned to provide contraception education and help patients make educated and empowered choices.