1. MALE CONTRACEPTION: ARE YOU ASKING THE QUESTIONS? Elizabeth Love and Kellie Rouse

2. Background & Purpose Our Purpose: To uncover the barriers for providers in addressing male contraceptive counseling in the primary care setting and help providers integrate male contraceptive counseling into his/her everyday practice

3. QUESTION…. What are the barriers to providing male contraceptive counseling in the primary care setting?

4. What the guidelines say… HEALTHY PEOPLE 2020 National Guidelines Clearinghouse

5. REVIEWING THE LITERATURE

6. Providers’ challenges: Perceived provider-level challenges Health system-level barriers Patient level barriers

7. Barriers in the rural setting: (level VI) Contraceptive counseling impacts contraceptive use: (level II) Race influences receipt of counseling: (level VI) The CHOICE Study: cross-sectional study: (level II)

8. Synthesis The studies analyzed in this literature review support the need for contraceptive counseling to help reduce the rate of unintended pregnancies. Ten out of the ten articles reviewed all placed emphasis on the provider’s responsibility to provide contraceptive counseling. While multiple barriers were identified the strongest theme was the lack of knowledge and training for primary care providers in effective and complete contraceptive counseling. Two of the ten articles identified the lack of reproductive health education provided for men despite their desire to be included in such educational counseling. A problem identified with the research is that it has focused primarily on women. Data on men and their sexual and reproductive health are outdated and limited forcing our analysis to include women and contraceptive counseling.

9. OUR RESEARCH PROJECT

10. Setting: Primary Care offices Participants: Primary care providers (NPs) The research process: 1.Survey participants on current practices 2.Education session 3.Post-education assessment of understanding of information

11. DATA ANALYSIS: Do you routinely provide male contraceptive counseling? 66.67% said YES, 33.33% said NO ------------------------------------------------------------- Do you discuss sexual activity, sexual involvement, or sexual health with male patients? 100% said YES ------------------------------------------------------------- Do you discuss the availability of contraceptive methods? 100% said YES

12. Do you encourage condom use? 100% said YES ----------------------------------------------------------- Do you educate on consistent and correct use of contraception? 100% said YES ----------------------------------------------------------- Do you discuss the risks and adverse outcomes of unintended pregnancies? 33.33% said YES, 66.67% said NO ----------------------------------------------------------- Do you discuss the importance of shared responsibility for pregnancy? 100% said NO

13. Do you discuss the financial and health benefits in preventing unintended pregnancy? 100% said NO ----------------------------------------------------------- Identify the barriers that prevent you from providing male contraceptive counseling in your clinic: 100% said “Time constraints”

14. References Akers, A., Gold, M., Borrero, S., Santucci, A., & Schwarz, E. (2010). Providers’ perspectives on challenges to contraceptive counseling in primary care settings. Journal of Women’s Health (15409996), 19(6), 1163–1170. doi:10.1089/jwh.2009.1735 Borrero, S., Schwarz, E., Creinin, M., Ibrahim, S. (2009). The impact of race and ethnicity on receipt of family planning services in the United States. Journal of Women’s Health, 18 (1), 91-96. doi: 10.1089/jwh.2008.0976 Cappiello, J., Beal, M. W., & Gallogly ‐ Hudson, K. (2011). Applying ethical practice competencies to the prevention and management of unintended pregnancy. Journal of Obstetric, Gynecologic, & Neonatal Nursing: Clinical Scholarship for the Care of Women, Childbearing Families, & Newborns, 40(6), 808–816. doi:10.1111/j.1552-6909.2011.01307.x Chuang, C., Hwang, S., McCall-Hosenfeld, J., Rosenwasser, L., Hillemeier, M., & Weisman, C. (2012). Primary care physicians’ perceptions of barriers to preventive reproductive health care in rural communities. Perspectives on Sexual & Reproductive Health, 44(2), 78–83. doi:10.1363/4407812 Counseling: Unintended Pregnancy. (n.d.). Retrieved October 15, 2013, from http://www.uspreventiveservicestaskforce.org/uspstf/uspspreg.htm Dirubbo, N. E. (2006). Counsel your patients about contraceptive options. The Nurse Practitioner, 31(4), 40–44. Egarter, C., Tirri, B.F., Bitzer, J., Kaminskyy, V., Oddens, B., Prilepskaya, V., Yeshaya, A., Marintcheva-Petrova, M., Weyers, S. (2013). Women’s Perceptions and Reasons for Choosing the Pill, Patch, or Ring in the CHOICE Study: a Cross-sectional Survey of Contraceptive Method Selection After Counseling. BMC Women’s Health, 13(9). Retrieved from http://www.biomedcentral.com/1472-6874/13/ Frost, J., Lindberg, L., & Finer, L. (2012). Young Adults’ Contraceptive Knowledge, Norms and Attitudes: Associations with Risk Of Unintended Pregnancy. Perspectives on Sexual & Reproductive Health, 44(2), 107–116. doi:10.1363/4410712 Lee, J.K., Parisi, S.M., Akers, A., Borrero, S., Schwarz, E.B. (February 8, 2011). The impact of contraceptive counseling in primary care on contraceptive use, Society of General Internal Medicine, 26 (7), 731-6. doi: 10.1007/s11606-011-1647-3 Mazurek, B., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare (2nd ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. National Guideline Clearinghouse (2009). Prevention of unintended pregnancy in adults 18 years and older. Retrieved from http://www.guideline.gov/content.aspx?id=34788&search=contraceptive+counseling Newbold, K., & Willinsky, J. (2009). Providing family planning and reproductive healthcare to Canadian immigrants: perceptions of healthcare providers. Culture, Health & Sexuality, 11(4), 369–382. doi:10.1080/13691050802710642 Nte., A.R., Odu, N., Enyindah., C.E. (September 2009). Male involvement in family planning: women’s perception. Nigerian Journal of Clinical Practice, 12(3), 306-310. Taylor, D., & James, E. A. (2011). An evidence ‐ based guideline for unintended pregnancy prevention. Journal of Obstetric, Gynecologic, & Neonatal Nursing: Clinical Scholarship for the Care of Women, Childbearing Families, & Newborns, 40(6), 782–793. doi:10.1111/j.1552-6909.2011.01296.x