Providers’ Knowledge, Perceptions and Views of Prescribing Long-Acting Reversible Contraception to Adolescents in a Southwest Community Health Center Item Type text; Electronic Dissertation Authors Schafer, Stephanie Lynne Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 02/10/2021 06:38:23 Link to Item http://hdl.handle.net/10150/626699 PROVIDERS’ KNOWLEDGE, PERCEPTIONS AND VIEWS OF PRESCRIBING LONG-ACTING REVERSIBLE CONTRACEPTION TO ADOLESCENTS IN A SOUTHWEST COMMUNITY HEALTH CENTER by Stephanie Lynne Schafer ________________________ Copyright © Stephanie Lynne Schafer 2017 A DNP Project Submitted to the Faculty of the COLLEGE OF NURSING In Partial Fulfillment of the Requirements For the Degree of DOCTOR OF NURSING PRACTICE In the Graduate College THE UNIVERSITY OF ARIZONA 2 0 1 7 2 3 STATEMENT BY AUTHOR This DNP Project has been submitted in partial fulfillment of requirements for an advanced degree at The University of Arizona and is deposited in the University Library to be made available to borrowers under rules of the Library. Brief quotations from this DNP Project are allowable without special permission, provided that accurate acknowledgment of source is made. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted by the head of the major department or the Dean of the Graduate College when in his or her judgment the proposed use of the material is in the interests of scholarship. In all other instances, however, permission must be obtained from the author. SIGNED: __Stephanie Lynne Schafer__________________ 4 ACKNOWLEDGMENTS Fulfillment of this Doctor of Nursing Project would not have been possible without the guidance and mentorship from a few select individuals. Your support and assistance was an invaluable gift that I will forever cherish. I wish to extend my sincere gratitude to Dr. Christy L. Pacheco, DNP, FNP-BC for her reassuring guidance and support not only throughout this project, but also in navigating through the most challenging aspects of this doctoral program. Her direction, insightful critiques, and sustained patience were invaluable. Her mentorship and leadership fueled my dedication to advocate for the underserved. Thank you for your generous support and commitment to teach us, your students. I am eternally grateful for your support and commitment, and your willingness to act as both my mentor and advisor. I would also like to thank my committee members, Dr. Sheila M. Gephart, PhD, RN and Dr. Gloanna Peek, PhD, RN, CPNP for contributing to my success. Thank you for presenting invaluable suggestions, comments and feedback that influenced the overall success of this project. I am grateful for your guidance. 5 DEDICATION Dedicated to the generous souls who continually challenge me to discover my purpose in life. To Dr. Jacqueline M. Reveal, thank you for being the most perfect companion over the past five years. Thank you for your encouragement, support, and constant positivity through this entire process. I am truly honored, and thankful, to be your friend and colleague. To my loving parents, Robert and Janice, my two greatest role models. I owe my aspirations, successes, and achievements all to you- you have given me the courage, strength, and motivation to soar and dream fearlessly since the day I was born. Thank you for teaching me how to serve in this world and advising me to constantly question- am I doing what is right and true, am I humble in taking the time to truly understand others, am I forgiving and demonstrating unwavering faith, and, most importantly, am I actively serving and loving the people around me. You both have taught me how to navigate through life in order to be the best version of myself. Thank you for this life I never deserved. I owe you two my life, and I love you endlessly. To my sister, Ashley, and my brother, Tyler, thank you for being my sidekicks for life. Ash, you have taught me to have unwavering faith and courage in every obstacle and battle life throws at you. Ty, you have taught me to stay true to my heart despite the challenges life brings. The older we grow, the closer we become, and the more I cherish our love for one another. To my Bubba and Brixton, thank you for your unceasing love. Thank you for teaching me how to take a step back to slow down in this busy life, to smell the flowers, to live in the moment, to not take life so seriously, to always choose joy, and to truly live each day like it’s my last. You make this mama’s heart so full. For your love, I am forever in your debt. To my Ross. Thank you for believing in me. Thank you for your sacrifices in allowing me to pursue my biggest dreams. Thank you for your endless encouragement and support, each and every day. Thank you for your unconditional and unwavering love, no matter the circumstances. Simply put, thank you will never be enough. You are my rock, and I love you so fiercely RJM. 6 TABLE OF CONTENTS LIST OF FIGURES .........................................................................................................................9 LIST OF TABLES .........................................................................................................................10 ABSTRACT ...................................................................................................................................11 INTRODUCTION........................................................................................................................12 Background Knowledge ..............................................................................................................12 Local Problem ..............................................................................................................................17 Purpose..........................................................................................................................................19 Study Question .............................................................................................................................19 FRAMEWORK AND SYNTHESIS OF EVIDENCE ..............................................................20 Theoretical Framework ...............................................................................................................20 Concepts ........................................................................................................................................21 Attitudes ............................................................................................................................21 Subjective Norm ...............................................................................................................22 Perceived Behavioral Control .........................................................................................22 Synthesis of Evidence ...................................................................................................................24 Provider Counseling and Recommendations ................................................................25 Lack of Knowledge and Appropriate Candidacy .........................................................25 Behaviors, Medical Risks and Adverse Outcomes ........................................................27 Personal Bias, Religion, Morals and Ethics ...................................................................28 Clinic Culture and Colleagues ........................................................................................29 Current State of Knowledge .......................................................................................................30 Strengths ...........................................................................................................................30 Weaknesses .......................................................................................................................30 Gaps in the Literature .....................................................................................................30 METHODS ...................................................................................................................................31 Design ............................................................................................................................................31 Ethical Considerations.................................................................................................................31 Setting............................................................................................................................................33 7 TABLE OF CONTENTS – Continued Participants ...................................................................................................................................34 Data Collection .............................................................................................................................35 Data Analysis ................................................................................................................................37 RESULTS .....................................................................................................................................38