Feasibility and Acceptability of the Delivery of Male Reproductive Health Screening and Education Within the Context of a Rural Utah Public Health Department

Background: The United States unplanned pregnancy rate is 45%, higher than other developed nations. Most interventions aimed at preventing unplanned pregnancy are targeted towards women, however, it requires both a female and male to achieve a pregnancy. In 2014, the Centers for Disease Control and Prevention (CDC) and the Institute of Medicine (IOM) issued recommendations for male sexual and reproductive healthcare, including screening and education around unplanned pregnancy and reproductive life planning. There is a paucity of literature describing ways to engage and provide males with reproductive health services. The Plan-Do-Study-Act Theoretical Framework was used to design a DNP project to address this issue. The specific goal of the project was to assess the feasibility and acceptability of a process involving screening and provision of relevant information about reproductive health for men seeking STI care at a rural Utah Public Health Department. This project is part of a larger endeavor to find effective ways of engaging men in family planning, while maintaining female reproductive autonomy, in an attempt to reduce unplanned or mistimed pregnancy rates. Methods: A quality improvement project was developed in collaboration with clinic staff, including an implementation protocol, screening tool and educational handouts on the topics of safe sex, contraception, preconception health, and reproductive life planning. An implementation period occurred for approximately two months, during which male patients seeking STI testing received the intervention. Feasibility and acceptability of the intervention was evaluated from the patient and staff perspective. Clinic staff completed pre and post-intervention surveys and partook in brief qualitative interviews. Male patients were asked to complete a post-intervention survey and participate in a brief qualitative interview. Results: A total of nine male patients were seen for STI testing during the intervention period and five received the intervention. Four men were included in results data. Two men (50%, n=2) completed the post-intervention survey and participated in brief semi-structured interviews. Both men described the intervention positively and reported gratitude for the educational handouts they received. Post-intervention survey responses demonstrated 80% (n=5) of staff agreedor strongly agreed (4 and 5 points on a 5-point Likert scale) that male reproductive screening and education should be conducted at the clinic and 100% (n=5) of staff agreedor strongly agreed (4 and 5 points on a 5-point Likert scale) that the intervention would benefit women. Despite staff support of the intervention, there were challenges in implementation. Conclusions: The low sample size of male patients prevents interpretation of data from the male perspective. Staff identified the main challenge in implementation as the low volume of male patients seeking STI testing, which prevented the intervention from becoming a routine part of their practice. Challenges notwithstanding, the nursing staff intended to continue use of intervention materials, including the male screening survey and patient education handouts. Further study through implementation at a clinical site with a larger volume of male patients is recommended.