Description
PLEASE, READ INSTRUCTIONS CAREFULLY. I HAVE ATTACHED THE OTHER SECTIONS OF THE PAPER SO THAT YOU KNOW WHAT IT IS ABOUT. PLEASE INCLUDE THE “the knowledge gaps.” IN THE LITERATURE REVIEW THEY FORGOT TO INCLUDE THE KNOWLEDGE GAPS.
In this section include the following:
A reference to the project’s benefits in terms of cost, time, and/or quality that address needs or changes, results, impacts, or consequences that the project has on people, programs, or institutions.
Goals and objectives that are measurable, shared, and hypothetically agreed on by all key stakeholders. They are directly linked to the concept of project success factors.
What variables need to be considered and and whether or not you have control over them.
For example, if you were to implement a clinic-wide practice change, would budget be an issue and how would you address that variable?
If you were to implement your study, consider how would you gather data. Would you choose the qualitative or quantitative method?
An explanation of what your research will provide to the community, or to social change.
A description of the desired outcomes: Specifically, state the purpose, focus, and viewpoint of the project as well as its expected accomplishments.
While you may not be implementing your project, you should have a goal in mind that relates to solving your problem.
Establish a timeline for accomplishing your project goal(s).
This section should be 3 pages in length, not including the cover or reference page, and should address the intended outcomes of your project. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
The project, aims, values, and desired outcomes are well developed and clear and thorough. Aims include detailed examples of projected features and functions. Values include implementation benefits for specific stakeholders. Desired outcomes expertly state the purpose, have a quality focus, and clearly describe the benefits that are expected to occur as a result of implementation.
49.2 to >45.0 pts
Approaches Expectations
The project, aims, values, and desired outcomes are somewhat clear but may be vague in places. Aims include somewhat vague examples of projected features and functions. Values include only general implementation benefits. Desired outcomes state the purpose, have a general focus, and generally describe the benefits that will occur as a result of implementation.
45 to >35.4 pts
Falls Below Expectations
The project, aims, values, and desired outcomes are somewhat clear, but lack many key details.
35.4 to >0 pts
Does Not Meet Expectations
The content is generally unclear. There is no clear evidence of what the project, aims, values, or desired outcomes are, or there might just be a list of project objectives.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
7.5 pts
Total Points: 75
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Problem Identification and Description
Yiranda Diaz
West Coast University
NURS 691A Culminating Experience I
Dr. Tracy Macdonald
September 17, 2023
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Problem Identification and Description
Prevention and control of Sexually transmitted diseases (STDs) and related conditions are
significant public health concerns and priorities. Sexually transmitted infections (STIs) are
mainly caused by parasites, viruses, and bacteria passed from one person to another through
semen, blood, or bodily fluids. However, apart from sexual intercourse, STIs can be transmitted
to infants during childbirth, pregnancy, shared needles, and blood transfusion. It is impossible to
know if someone has STIs in the early stages of the illness, even if they seem healthy. STDs and
unwanted pregnancies are common in nearly every society, affecting adults and adolescents.
Teenage pregnancy and unwanted pregnancy are increasingly affecting the livelihood of many
women, forcing young adults to become mothers earlier than desired. The clinically identified
problem in this paper is the unwanted pregnancies and contraction of STDs due to unprotected
sexual activity. This paper describes the clinical problem, target population, and significance of
the clinical intervention and health promotion.
PICOT Question
Among adolescents (P), can best sexual health education and promotion (I) compared
with no interventions (C) prevent STIs and unwanted pregnancy (O) within one year (T)?
Clinical Setting
In the United States, sexual health education is inconsistent with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices. However, despite sexual health promotion activities, rates of STIs in the United States
are on the rise. The best clinical setting to address and promote sexual health and unwanted
pregnancy is the primary care unit, which is the first point of contact for millions of Americans
seeking healthcare services. The intervention initiative will be in a primary care facility with an
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obstetrician-gynecologist (OBGYN) unit that deals with women and mothers. The unit provides
services related to reproductive health and women’s well-being. It encompasses health clinics
that serve pregnant women, young adolescent girls, and boys needing urgent clinical
interventions and emergencies. Thus, the OBGYN unit in primary care is the perfect clinical
setting to promote sexual health and reach both males and females seeking reproductive health.
OBGYN Service and Population Group
OBGYN unit offers various services for women planning pregnancy, including prenatal
care, pregnancy services, and postpartum care. It also provides services to young mothers,
monitoring baby’s health, delivery, and postpartum care. Likewise, OBGYN offers patients
services outside pregnancy, including fertility issues, preventive maintenance, gynecologic
procedures, and bleeding complications. With varied clinical specialties, adolescents can access
solutions to address female reproductive organs, both pregnant and non-pregnant women. Even
though people visit primary care with issues unrelated to health problems, unwanted pregnancy
can create more significant problems for young mothers, including psychological issues. Many
adolescent girls and young women visit the clinic seeking alternative solutions to unwanted
pregnancies, including abortion. Even though other medical conditions or complications can lead
to the termination of the pregnancies, young mothers visiting the clinic have other worrying
concerns related to STIs, particularly herpes, HPV, syphilis, gonorrhea, and chlamydia.
Statement Of The Problem and Target Population
In the United States, sexual health education is inconsistent, with varying methods and
information nationwide. Education is vital in empowering young people to develop safe sex
practices (Walchonski, 2020). However, despite sexual health promotion activities, rates of STIs
in the United States are on the rise. Multiple interventions have been implemented to promote
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women’s health in various settings, including promoting adolescent education to enhance sexual
health. These interventions include comprehensive sexual education, cognitive behavioral
interventions, abstinence-only education, and dyad education for parents and teenagers.
However, sexual behaviors among adolescents are influenced by various factors,
including peer pressure, individual environment, parental involvement, policy, and social
situations. Many schools promote abstinence-only, while others offer HIV education with a
choice of content and nuanced values. Despite the education enshrined in school and education
policy, STI rates are on the uptrend, disproportionately among teens. There is an urgent need to
successfully promote awareness to enhance understanding of the risks associated with sex and
adolescents’ reckless practices. This may require state and federal government policy to enforce
teenage reproductive health promotion. Assessing the problem’s dimension and planning
effective efforts to address it is challenging, given the magnitude of social media influence on
today’s teenagers.
Clinical Significance of the EBP Approach
According to the CDC (2021), STIs are rising, compromising national health, with over
2.5 million cases reported in 2021 for syphilis, gonorrhea, and chlamydia. WHO statistics
indicate that over 1 million new cases are reported daily worldwide. The majority are young
people between 15-34 years. Even though most STIs are treatable with antibiotics, they increase
risks for adverse events, including infertility, stillbirth, inflammatory disease, neonatal death, and
HIV infections. Increased over-the-counter prescription of antibiotics has increased resistance
from STI strains that are becoming difficult to treat (WHO, 2023). Research has shown that STIs
among college student is mainly due to a lack of knowledge and awareness of STDs
(Amirkhanzadeh et al., 2019).
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Therefore, the best approach is required to overcome teenage and unwanted pregnancies.
Another research in India offers insight into misinformed young people on emergency
contraception that can resolve unwanted pregnancies (Davis et al., 2020). Evidence-Based
Practice (EBP) provides valuable information that guides interventions and policy development
for influential women’s reproductive health development. It is crucial to understand the
effectiveness of the best sexual education approach to inform policymakers, particularly in
resource allocation and funding of school-based education. This project’s clinical significance is
applying EBP to find the best reproductive health interventions to close the knowledge gap
among young girls to reduce high cases of STIs and unwanted pregnancies.
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References
Amirkhanzadeh Barandouzi, Z., & Cong, X. (2019). Knowledge of sexually transmitted diseases
among college students in the USA. Journal of Client-Centered Nursing Care, 5(2), 7380. http://dx.doi.org/10.32598/JCCNC.5.2.73
CDC (2021). Sexually Transmitted Disease Surveillance 2021.
https://www.cdc.gov/std/statistics/2021/default.htm
Davis, P., Sarasveni, M., Krishnan, J., Bhat, L. D., & Kodali, N. K. (2020). Knowledge and
attitudes about the use of emergency contraception among college students in Tamil
Nadu, India. Journal of the Egyptian Public Health Association, 95, 1-11.
https://doi.org/10.1186/s42506-019-0030-9
Walchonski, C. F. (2020). Best Youth Education Methods for Sexually Transmitted Infection
Prevention.
https://cornerstone.lib.mnsu.edu/cgi/viewcontent.cgi?article=1974&context=etds
WHO (2023). Sexually transmitted infections (STIs). https://www.who.int/news-room/factsheets/detail/sexually-transmitted-infections-(stis)
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The Integrative Literature Review
Yiranda Diaz
West Coast University
NURS 691A Culminating Experience I
Instructor: Dr. Tracy Macdonald
September 23, 2023
2
The Integrative Literature Review
Sexual health education has a significant role in preventing STIs and unplanned
pregnancies among young adults. Effective reproductive health plans can offer adolescents the
proper knowledge and insights to base on when making informed decisions concerning their
reproductive health. Opening an intervention center like the OBGYN will help provide a wide
range of reproductive topics that will be age-appropriate. Moreover, the intervention aims to
bridge the existing gap in sexual health to increase abstinence and reduce incidences of unwanted
pregnancy. Various scholars have indulged in the topic to prove the effectiveness of quality
sexual health education.
Mantula et al. (2023) did their study to prove the effectiveness of inclusive sexual health
education. According to the authors, sexual well-being is a state of wholeness in aspects relating
to reproduction. Therefore, sexual health entails effective counseling and providing people with
the proper knowledge, explaining available resources related to sexuality, and addressing any
barriers that compromise knowledge acquisition. The scholars further prove that adolescents
have long been engaging in risky sexual conduct due to the unavailability of effective sexual
education.
Although youths have been accessing details related to sexuality in schools, churches, or
within their families, education has not been enough to induce the correct behavioral change.
Comprehensive sexual education entails emphasizing behold information but providing support
that motivates young adults to attain the right life skills and have appropriate attitudes.
Moreover, practical education should also focus on growth and development, appropriate sexual
behaviors, pregnancy, and health issues related to unethical sexual conduct.
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Basically, according to Mantula et al. (2023), effective sexual education is necessary for
addressing adolescents’ well-being. Therefore, tailored education programs that offer age-related
and continuous reproductive health updates are appropriate in the contemporary adolescent
world. The education should cover broad aspects related to relationships, contraceptives, the
effects of pregnancy, the necessity of abstinence, and the responsibility of a teen to lead a moral
life. Lastly, ensuring that the education programs are related and friendly is essential while
considering these topics.
Mbizvo et al. (2023) explain that adolescents’ health education, especially about sexuality
and reproduction, is essential to development. The study’s outcomes indicate that early and
unintentional pregnancies are becoming a hot topic among adolescents. The increasing
pregnancy rates indicate that youths have been engaging in risky sex behaviors, increasing their
chances of acquiring HIV and STIs. That implies that adolescents have a high probability of
unhealthy abortions and childbirth health issues. The central contributing aspect is the lack of
comprehensive sexual education to increase their knowledge about sexual health.
The research topic entails identifying if comprehensive sexual education can reduce the
chances of these instances. The researchers imply that effective sexual education significantly
offers young adults the appropriate details about their sexual health. Moreover, education
minimizes assumptions and life skills that help adolescents enhance their decision-making
abilities to choose a proper sex life. That can help reduce the increasing rates of HIV and
unwanted pregnancies. Such an outcome supports the research topic since it helps evaluate if
effective education can reduce incidences of STDs.
Aguirre & Carrión-Yaguana (2023) comprehensively evaluated the impact of
comprehensive sex education in Ecuador. Adolescents have a promising future in the society.
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However, many challenges, like early pregnancies and risky sexual behaviors, have been
significant among youths. The main reason is adolescents lack the necessary and timely
information about sexuality. Effective sexual and reproductive education motivates individuals
to make competent decisions about their sex lives. Poor knowledge of sexuality is one of the
significant reasons why STIs and unwanted pregnancies have become common among teens.
Adolescents do not have the correct information about contraceptives and the risks and impact of
engaging in early sexual activities.
Therefore, as the study indicates, integrating comprehensive sex education in school
programs helped reduce unwanted pregnancies in Ecuador. The unlimited benefits of sexual
education are evident, supporting the research topic. A reproduction health program that
addresses diverse aspects of sexual life to provide youths with the correct information about their
growth and the effects of early sexual activities is the best solution. That is because thorough
education provides insights on abstinence and preventing STIs.
However, providing abstinence-related education and comprehensive sex education
appears to be the best remedy. Informing adolescents about sexual engagement and
contraceptives has an unpromising future since it can be compromised. However, diverse
education provides teens with the correct information about the dangers of engaging in sexual
behaviors. Teens have the chance to identify how early pregnancies can affect their education,
parents, and career dreams. They also get to understand STIs’ effects on their reproductive
health. That helps create a knowledge base that allows adolescents to make the right decisions
about their sexual lives.
Mark & Wu (2022) indicates that sex education in America has been a major topic
among researchers and legislators. The primary reason is that teen birth has been increasing
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recently. Most of these births are unwanted and unplanned. The necessity of comprehensive sex
education is evident even with the federal government funding programs like abstinence-only sex
education to provide teens with the right tips about immoral behaviors and the value of
abstaining till marriage. Based on the study outcomes, emphasizing sex education has helped
reduce teen pregnancy by more than 2%. That implies that focusing on more individualized
education strategies can be promising. Tailoring education programs to address the diverse
causes of early pregnancy and STIs can significantly save American teens. Moreover, these
education programs can support addressing societal barriers that hinder teens from accessing the
proper and comprehensive information about sexuality.
Mohamed et al. (2023) provide an analysis of the significant causes of unwanted
pregnancies among teens. Early pregnancy has high risks of premature births or delivering
unhealthy kids. Moreover, early pregnancy increases the economic burden on parents and
introduces mental complications to adolescent mothers. Therefore, finding a remedy to this issue,
as the article implies, can help reduce the impacts and complications of early sexual engagement.
Comprehensive sexual education is the primary solution to increasing unwanted pregnancies.
According to the article, effective sexual education should provide detailed sessions about
contraceptives and making competent decisions about sexual life. Such an analysis supports the
idea that a comprehensive reproduction education would effectively address the increasing rate
of adolescents.
Agbor et al. (2021) evaluate how introducing sex education to youths at an early stage
can help reduce cases of early pregnancy. As the researcher indicates, many teens engage in
unethical behaviors due to societal and economic conditions. Moreover, these young adults lack
the knowledge to avoid STIs and unintended pregnancies. Little engagement between families
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and children has also increased STDs and unwanted pregnancies. Therefore, comprehensive sex
education has become relevant and supportive for teens despite the challenges they are currently
experiencing. The topic of sexual education has for a long time been considered for married
people. However, these assumptions have proven ineffective, and introducing comprehensive
sexual education has indicated its necessity amongst teens. This education aims to minimize the
chances of adverse effects and STIs. The education provides awareness on enhancing life quality
and enjoying sexuality.
However, as the authors signify, a well-planned and structured education plan is the best
way to address these challenges. Many education programs have failed due to their inconsistency
and shallowness of the topic. They lack the details to inform teens about generating essential life
skills like abstinence and living a moral life. Therefore, cooperating with the correct information
in education would have a promising future for teens.
Lastly, Pires et al. (2021) explain that adolescent pregnancy is a worldwide medical issue.
The main contributing factors include poor female education and lack of knowledge. Lower
perceptions of the topic have been a significant reason why unwanted pregnancies have become
dominant today. Also, teens lack the appropriate expertise on contraceptives and engage in risky
sexual behaviors. Therefore, finding the right interventions, such as comprehensive sex
education, would limit these barriers. The research also provides insights into why adolescents
engage in sexual behavior at an early stage. The primary aspect is having older partners
introduce them to sexual activities before maturity. This information forms the foundation for an
effective education system where adolescents gain the correct information about their sexual
lives.
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Summary of literature review
All articles in the literature review prove that early pregnancies and STIs among teens
have become a significant healthcare issue today. Many teens face major challenges due to their
introduction to sexual behaviors by their peers and older partners. Moreover, knowledge
inadequacy and a lack of a support system have contributed to these issues. Many teens lack the
proper sexual life knowledge, compromising their ability to make informed decisions. Without
the appropriate expertise, it is hard to make the right choices. Therefore, introducing a
comprehensive education system proves to be an effective remedy for addressing this challenge.
Moreover, introducing the education mechanism will reduce the burden on the advanced
practice nurse. There will be a limited burden of addressing STIs and treating premature births.
Also, the identified gaps, including the causes of significant unwanted pregnancies and why
available programs fail, provide a baseline for the nurse to develop comprehensive education
plans that help address unintended teen pregnancies. Also, the nurse will be able to advocate for
the right resources that connect adolescents with the right support system.
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References
Agbor, P. E., Chile, O., & Ogu, E. N. (2021). Influence of Sex Education on Early Pregnancy
among Adolescent Female Students in Port Harcourt Metropolis: Implication for Students
Academic Performance. https://seahipaj.org/journals-ci/sept-2021/IJIHCR/full/IJIHCR-S2-2021.pdf
Aguirre, K., & Carrión-Yaguana, V. D. (2023). Empowering youth: the impact of comprehensive
sex education on teenage pregnancy in Ecuador (No. wp-2023-107). World Institute for
Development Economic Research (UNU-WIDER).
https://www.wider.unu.edu/sites/default/files/Publications/Working-paper/PDF/wp2023107-empowering-youth-impact-sex-education-teenage-pregnancy-Ecuador.pdf
Mantula, F., Chauraya, Y., Danda, G., Chaibva, C. N., Ngwenya, T., Gwatiringa, C., & Chamisa,
J. A. (2023). Perspective Chapter: Sexual Health Interventions for Adolescents. In Sexual
Education Around the World-Past, Present and Future Issues. IntechOpen.
https://www.intechopen.com/chapters/1137866
Mark, N. D., & Wu, L. L. (2022). More comprehensive sex education reduced teen births: Quasiexperimental evidence. Proceedings of the National Academy of Sciences, 119(8),
e2113144119.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872707/#:~:text=A%20consistent%20fi
nding%20from%20observational,use%20(29%E2%80%9331).
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Mbizvo, M. T., Kasonda, K., Muntalima, N. C., Rosen, J. G., Inambwae, S., Namukonda, E. S.,
… & Kangale, C. (2023). Comprehensive sexuality education linked to sexual and
reproductive health services reduces early and unintended pregnancies among in-school
adolescent girls in Zambia. BMC public health, 23(1), 1-13.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15023-0
Mohamed, S., Chipeta, M., Kamninga, T., Nthakomwa, L., Chifungo, C., Mzembe, T., … &
Madise, N. (2023). Interventions to prevent unintended pregnancies among adolescents:
A rapid overview of systematic reviews. https://assets.researchsquare.com/files/rs2568862/v1/050a2163-7cde-4133-8f4d-608a5ac40908.pdf?c=1679000290
Paton, D., Bullivant, S., & Soto, J. (2020). The impact of sex education mandates on teenage
pregnancy: International evidence. Health economics, 29(7), 790-807.
https://onlinelibrary.wiley.com/doi/full/10.1002/hec.4021
Pires, R., Araújo-Pedrosa, A., Pereira, J., & Canavarro, M. C. (2021). How Can Unintended
Pregnancies Be Prevented among Adolescents Who Engaged in Sexual Intercourse at
Earlier Ages? The Role of Female Education and Partner Age Difference. International
Journal of Environmental Research and Public Health, 18(20), 10631.
https://www.mdpi.com/1660-4601/18/20/10631
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