(63) The Development of a Standardized Approach for Providing Reproductive Health Education to Adolescents and Young Adults with Cystic Fibrosis

Background: The impact of cystic fibrosis (CF) on the reproductive system is significant. As people with CF experience longer and healthier lives, education on topics involving reproductive health become more pertinent, especially for adolescents and young adults. The Cystic Fibrosis Care Center at Children’s Mercy Kansas City (CMKC) recognized the potential for inconsistency among providers and care teams when providing this education.

Methods: An assessment of current center practices was completed via provider survey. Results revealed large variability in the methods for providing reproductive health education in the ambulatory care setting. There were differences in terms of the age at which education was first offered, the overall provider comfort level completing education, and topics covered. A multidisciplinary quality improvement (QI) group was formed with the aim of standardizing educational content and developing processes to ensure that reproductive health education was consistently offered starting at age 12. The group reviewed available literature and existing CF reproductive health educational materials. A curriculum was developed with suggested content based on age and sex. Content included topics such as puberty, fertility, contraception, family planning, urinary incontinence, and sexually transmitted infections. A catalogue with preferred resources, educational materials and referral lists was developed for CF team members to utilize. Provider and nurse teams were requested to offer reproductive health education annually. CF Center pharmacists were asked to assist with additional counseling for medication related topics. CF Center social workers were available to provide additional support and assistance for sensitive matters. A standardized form was built in the electronic medical record so Teams could document when reproductive health education was completed. The project was implemented in October of 2021. The occurrence of education sessions provided during clinic was tracked and data reviewed monthly.

Results: One hundred and twenty-five people with CF aged 12 and older are currently cared for at CMKC and are eligible for education regarding reproductive health. In the five months following implementation, twenty-one educational sessions occurred. This represents 17% of the target population. Education was provided for 18 (86%) females and three males (14%). Education was provided by nurses and providers equally.

Conclusions: The rates at which reproductive health education is being completed post project implementation is lower than expected, especially in males. Busy clinic schedules and patient/family time constraints may lead to a lack of available time to provide education. Other contributing factors may include team members failing to document that education was provided and not identifying eligible patients in pre-clinic huddles. This project is ongoing, and the QI taskforce is meeting monthly and utilizing Plan-Do-Study-Act (PDSA) cycles to promote improvement.

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