Persistent Link:
http://hdl.handle.net/10150/228158
Title:
Program Evaluation of a County Reproductive Health Program
Author:
Pacheco, Christy Lee
Issue Date:
2012
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.
Abstract:
Northern Arizona women of childbearing age are at disproportionately higher risk for poverty and persistent health disparities in maternal risk factors and maternal child health outcomes. Preconception care is a lifespan and population-based approach to providing health promotion activities to women of childbearing age to improve the health of women, their families, and communities. The county's Reproductive Health Program offers comprehensive reproductive and preconception healthcare to underserved women and men throughout the county without regard for ability to pay, serving as a critical safety net for this vulnerable population. A formative evaluation was performed using the CDC's Framework for Program Evaluation in Public Health and retrospective chart review to assess program implementation. In 2010, 1,561 patients received care over 2,575 visits; the majority of patients (69.4%) were women of childbearing age (females 15-44). Most patients (92.9%) were ≤ 150% FPL, and uninsured (77.8%). Program patients were racially/ethnically diverse, with nearly half identifying themselves as White (48.8%), followed by Hispanic (35.3%), and American Indian/Alaskan Native (11.6%). Program reach was limited. Comprehensive medical and social risk assessment and health promotion activities were consistent with evidence-based recommendations. More than 3,400 STI and pap screenings were performed, with identification of 178 abnormal results at the primary program site. One hundred forty-five females had a positive pregnancy test at the primary program site, one-third (33.1%) to teens. For women of childbearing age not trying to become pregnant (98%), a range of family planning methods were provided, which most commonly included oral contraception (36.9%), followed by condoms (15.4%), and Depo-Provera injection (12.6%). More than 10% of low-income females 15-44 received referrals for further medical care not provided with program. Logistic regression analysis revealed program visits associated with a decreased risk of unplanned pregnancy, though this was not significant (OR 0.87, 95% CI 0.59-1.29, p>0.05). In conclusion, this program provided evidence-based preconception care to underserved women of childbearing age, though reach was limited. Additional studies are recommended to explore patient needs and barriers to improve reach and tailor services. Development of a community advisory council is recommended to guide program activities.
Type:
text; Electronic Dissertation
Keywords:
preconception; program evaluation; reproductive health; teen pregnancy; Nursing; childbearing; maternal child health
Degree Name:
D.N.P.
Degree Level:
doctoral
Degree Program:
Graduate College; Nursing
Degree Grantor:
University of Arizona
Advisor:
Reel, Sally

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleProgram Evaluation of a County Reproductive Health Programen_US
dc.creatorPacheco, Christy Leeen_US
dc.contributor.authorPacheco, Christy Leeen_US
dc.date.issued2012-
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © 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.en_US
dc.description.abstractNorthern Arizona women of childbearing age are at disproportionately higher risk for poverty and persistent health disparities in maternal risk factors and maternal child health outcomes. Preconception care is a lifespan and population-based approach to providing health promotion activities to women of childbearing age to improve the health of women, their families, and communities. The county's Reproductive Health Program offers comprehensive reproductive and preconception healthcare to underserved women and men throughout the county without regard for ability to pay, serving as a critical safety net for this vulnerable population. A formative evaluation was performed using the CDC's Framework for Program Evaluation in Public Health and retrospective chart review to assess program implementation. In 2010, 1,561 patients received care over 2,575 visits; the majority of patients (69.4%) were women of childbearing age (females 15-44). Most patients (92.9%) were ≤ 150% FPL, and uninsured (77.8%). Program patients were racially/ethnically diverse, with nearly half identifying themselves as White (48.8%), followed by Hispanic (35.3%), and American Indian/Alaskan Native (11.6%). Program reach was limited. Comprehensive medical and social risk assessment and health promotion activities were consistent with evidence-based recommendations. More than 3,400 STI and pap screenings were performed, with identification of 178 abnormal results at the primary program site. One hundred forty-five females had a positive pregnancy test at the primary program site, one-third (33.1%) to teens. For women of childbearing age not trying to become pregnant (98%), a range of family planning methods were provided, which most commonly included oral contraception (36.9%), followed by condoms (15.4%), and Depo-Provera injection (12.6%). More than 10% of low-income females 15-44 received referrals for further medical care not provided with program. Logistic regression analysis revealed program visits associated with a decreased risk of unplanned pregnancy, though this was not significant (OR 0.87, 95% CI 0.59-1.29, p>0.05). In conclusion, this program provided evidence-based preconception care to underserved women of childbearing age, though reach was limited. Additional studies are recommended to explore patient needs and barriers to improve reach and tailor services. Development of a community advisory council is recommended to guide program activities.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectpreconceptionen_US
dc.subjectprogram evaluationen_US
dc.subjectreproductive healthen_US
dc.subjectteen pregnancyen_US
dc.subjectNursingen_US
dc.subjectchildbearingen_US
dc.subjectmaternal child healthen_US
thesis.degree.nameD.N.P.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplineNursingen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorReel, Sallyen_US
dc.contributor.committeememberMichaels, Cathleenen_US
dc.contributor.committeememberCrist, Janiceen_US
dc.contributor.committeememberReel, Sallyen_US
All Items in UA Campus Repository are protected by copyright, with all rights reserved, unless otherwise indicated.