District V project wins ACOG Junior Fellow Initiative Toolkit Contest

MacDonald Women’s Hospital Residents        

JFIT project leader Kelly Kuo, MD, with fellow Case
Western University Hospitals MacDonald Women’s
Hospital residents Anne G. Sammarco, MD, and
Amber A. Bondurant, MD

Kelly Kuo, MD, project leader

The economic burden of unplanned teenage pregnancies in the US is estimated to exceed $9 billion annually. Government efforts to decrease teen pregnancy rates have been ongoing for decades, with reproductive health education often the subject of political and ideological debate. Specific requirements regarding the content and breadth of reproductive health-related curricula vary widely by state. In Ohio, for example, where comprehensive sex education is not mandatory, a significant percentage of students are taught abstinence without corresponding information regarding contraception and safe sex.

Evidence suggests that comprehensive approaches to sex education, rather than abstinence-only programs, better equip young people to make healthy and mutually protective relationships. At my resident clinic at Case Western University Hospitals MacDonald Women’s Hospital, approximately 25% of the obstetric population is aged 15 to 19, and 30% of patients screen positive for sexually transmitted diseases (STDs) in any trimester. Based on our experiences with young patients—the overwhelming majority for whom pregnancy is neither planned nor desired—we decided to go beyond the office setting to create a resident-led educational series on reproductive health for a local inner-city school.

        Reproductive Anatomy and Pregnancy Class

Resident-led educational session on reproductive
anatomy and physiology

In November 2012, using funds we received from the District V Junior Fellow Initiative Toolkit Contest, we created customized anatomy posters and purchased pelvic models for the school. Our goal was to provide 60 students with a comprehensive reproductive health curriculum, despite the challenges of a low-resource setting.

Over the course of three days, six residents taught sessions on reproductive anatomy and physiology, STDs, contraception, and negotiating safe relationships. Lessons included lectures, interactive games and discussion, and informal question-and-answer sessions. Pre- and post-test surveys demonstrated significant improvements in students’ knowledge of human anatomy, contraception, and safe sex practices.

The percentage of students able to name at least three forms of contraception increased from 30% to 72.5%. The percentage able to name at least three STDs increased from 20% to 75%. In the post-test questionnaire, 95% of students correctly answered “condoms” and/or “abstinence” as the only forms of contraception that also prevent STD transmission, compared with only 10% at the beginning of the study.

Anonymous Questions from Students         

Anonymous questions collected from students
after educational session


Residents benefited as well, reporting increased comfort with counseling young teens and improved understanding of government policy as it relates to sex education. Feedback from teachers and residents reflected the perception that investing in reproductive health education can be both valuable and cost-efficient, particularly when community partnerships are utilized or created.

The socioeconomic burden of teen pregnancy certainly justifies comprehensive efforts to improve reproductive health education. Physicians are well-equipped to assist with providing young adults with accurate information, with the reciprocal benefits of increased cultural competency, counseling skills, and understanding of government policy as it relates to sex education.

I encourage you to read more about our project and all the other 2012 JFIT Contest submissions on the Junior Fellow website.