Assigment .Apa seven . All instructions attached.

1

Capstone Part I: PICOT Assignment

Ernesto Cisneros

Florida National University

MSN Capstone Project-DBX-DL01

Dr. Carmen Lazo

July 7, 2024

2

Sexually transmitted infections (STIs) are a substantial public health concern, particularly

among 13-19-year-olds. STIs disproportionately affect this group due to changing sexual habits,

insufficient sex education, and uneven access to prevention methods. Only 25% of sexually

active Americans are 15-24 years old, yet they account for half of new STI diagnoses (CDC,

2020). Adolescent STI prevention and management need targeted therapy. The project's

objective is to investigate how public STI prevention resources impact on knowledge and

attitudes of teens. The study will establish whether promoting testing, condoms and education

access promotes STI prevention. The research evaluates the knowledge and attitudes of teens

towards safer sexual activities in a bid to ascertain that preventive practices decrease the cases of

STI infection. The measures used are STI knowledge, preventive services use, and self-efficacy

in conducting safer sex practices. This study informs health practice and policy to reduce STIs in

young people and improves population health and quality of life for this vulnerable age group.

PICOT Question

In adolescents aged 13-19 years (P), how does access to publicly available STI

prevention resources (I) compared to limited access (C) influence knowledge and attitudes

towards STI prevention (O) over an 8-week period (T)?

Vulnerable Population

STIs are at a high frequency within the 13-19-year-old category due to many reasons,

including socioeconomic circumstantial determinants of health that affect their behavior and

access to care. One's class, education, and culture have much to do with the possibility of

acquiring an STI. Low-income teenagers may not be able to access appropriate knowledge for

comprehensive sex education and prevention if they are inferior, uninsured, or out of work. This

3

limitation can encourage deception and unsafe sexual practices, thereby heightening the risks of

acquiring STIs (Walensky, 2021).

Sexuality and STI norms in culture and society may potentially raise risk. Sexual health

is stigmatized in many communities, leading in inadequate knowledge and avoidance of

preventive treatment. This cultural climate makes it tougher for teens to make informed sexual

health decisions and get STI prevention. For instance, Hispanic and African American teens are

more affected by STIs than Caucasian teenagers (CDC, 2020).

Risk factors for STI prevention in adolescents include early sexual debut, inconsistent

condom use, having many sexual partners, and drug use. Considering the exposure and poor

prevention, teenagers engaged in such activities are more likely to develop STIs. Idaperéa

Monteiro et al. (2023) describe how inadequate parental supervision, peer influence, and media

exposure to risky behaviors may increase these risks, proving the impact of social and behavioral

determinants of adolescent sexual health.

These are issues that require interventions addressing socioeconomic determinants of

health that predispose an adolescent to STI acquisition. For this reason, a healthcare provider

may help an adolescent make informed decisions in matters concerning their sexual health by

participating in activities reducing socioeconomic disparities, funding relevant, culturally

appropriate education, and enhancing access to convenient and private care. This is of great

importance for the decrease of STIs among teenagers and the promotion of healthy, diverse

populations.

Literature Review

Recent peer-reviewed research shows several effective STI prevention techniques for

teenagers. Cannovo et al. (2024) stress the need for culturally sensitive and accessible sexual

4

health care and thorough STI testing and education for adolescents and young adults. Their

Macerata, Italy, research reveals that STI tests using swabs and blood are effective across age

groups and genders. Based on demographics and global comparisons, this approach diagnoses

prevalent STIs and offers prevention. Gogineni et al. (2021) stress STI screening and treatment

for U.S. teens. The MyVoice countrywide survey found that most teenagers and young adults are

willing to discuss STI care with their partners. It's possible to prioritize juvenile STI testing and

destigmatization.

Budiarti et al. (2024) point out that Indonesian teenagers' STD prevention knowledge,

attitudes, and behaviors are linked. Their correlational study demonstrates that comprehensive

sexual health education increases teens' STD awareness and prevention. This emphasizes the

necessity for sexual conduct education. These findings imply that teenagers should get

information, accessible testing, and culturally appropriate STI prevention. Community-based

outreach, school-based health education, and STI testing in routine healthcare have decreased

STI prevalence and improved long-term sexual health outcomes for adolescents globally.

.

Proposal

Education, resources, and community engagement are key to STI prevention for teens,

according to research. Using existing infrastructure, the effort will target schools and community

health centers for maximum impact. The intervention will standardize sexual health education

for 13-19-year-olds. STI prevention, contraception, and sexual decision-making will be covered.

Community nurses and school health educators will provide culturally sensitive and

developmentally appropriate programs. Teaching the software requires educational materials,

multimedia technologies, and educator training. Teachers, administrators, community leaders,

5

and healthcare professionals will be stakeholders, facilitating buy-in and support across

educational and healthcare contexts.

Community health centers will provide youth-friendly STI clinics to increase access.

These clinics will provide discreet STI testing, contraceptive advice, free condoms, and

educational brochures. Nurse practitioners and advanced practice nurses will staff these clinics,

assess, advise, and recommend additional therapy for adolescents. This initiative aims to reduce

teen stigma and ignorance about healthcare.

Intervention will be scheduled. Phase one curriculum development and stakeholder

involvement will last three months. Phase two includes six months of seminars and youth-

friendly clinics. Pre- and post-intervention surveys will evaluate adolescent STI prevention

knowledge, attitudes, and behaviors. Evaluation criteria include STI screening rates, condom use,

and sexual safety confidence.

This intervention is practical in advanced nursing because nurse practitioners may lead

educational activities, provide clinical care, and engage with community stakeholders. Clinical

skills and patient-centered approach may help nurses create trust and facilitate frank sexual

health discussions with teens. Working with school and community health initiatives promotes

sustainability and scalability, increasing adolescent health. This evidence-based intervention

helps teens make informed sexual health decisions by addressing STI prevention issues.

Theoretical Foundation

Stages of change Theory, more commonly known as the Transtheoretical Model (TTM),

supports behavior change, particularly in adolescent STI prevention. This notion defines

behavior modification as precontemplation, contemplation, preparation, action, and maintenance.

6

Information, beliefs, and environmental cues determine each stage's desire and motivation to

change behavior (Velicer et al., 1998).

TTM STI prevention in teens must address an assessment of readiness for behavior

change. Most teenagers are uninformed of the dangers of unprotected sexual conduct or ill-

informed, and most of them will be in either pre-contemplation or contemplation. As such, TTM

offers a chance to tailor teaching to the stages of teenagers. For instance, at precontemplation,

education can be provided on STIs and their effects while, at preparation and action, processes

for making decisions and how to carry out condom use and screening are offered (Karatana et al.,

2022).

Moreover, TTM stages denote the dynamic nature of adolescence and adolescent

behavior. Because of media, social interactions, and personal experience, adolescents' health

beliefs and practices related to sexuality may turn around overnight. TTM phases would help the

nurse and other healthcare professionals individualize their aid and advice with a teenager's

readiness for change. This sensitive population will need maintenance, checking, and

reinforcement that will sustain improvement in helpful responses without STI transmission. The

Transtheoretical Model enhances the theoretical and practical effectiveness of this intervention in

long-term behavior change regarding adolescent sexual health.

Conclusion

The public health has to address high rates of adolescent STIs, as they have long-term

effects on human well-being and healthcare systems. Based on the Transtheoretical Model, some

interventions provide teens with strategies for STI transmission prevention and upkeep of sexual

health. Quality sexual information, easily accessible health care, and community involvement

eliminate barriers to preventative care, promote informed decision-making, and hence may

7

decrease the cost of STI treatment and save a teen's life. Therefore, future studies should be

geared toward assessing the scalability, durability, long-term behavior change, and STI incidence

patterns of such therapies across communities and situations. Education-based initiatives that

make STI prevention increasingly common among teens around the globe should evolve in light

of cultural norms that are changing and other new requirements in health delivery.

8

References

Cannovo, N., Bianchini, E., Gironacci, L., Garbati, E., Di Prospero, F., Cingolani, M., Scendoni,

R., & Fedeli, P. (2024). Sexually Transmitted Infections in Adolescents and Young

Adults: A Cross Section of Public Health. International Journal of Environmental

Research and Public Health, 21(4), 501. https://doi.org/10.3390/ijerph21040501

CDC. (2020). Sexually transmitted disease surveillance 2020.

https://www.cdc.gov/std/statistics/2020/2020-SR-4-10-2023.pdf

Gogineni, V., Waselewski, M. E., Jamison, C. D., Bell, J. A., Hadler, N., Chaudhry, K. A.,

Chang, T., & Mmeje, O. O. (2021). The future of STI screening and treatment for youth:

a National Survey of youth perspectives and intentions. BMC Public Health, 21(1).

https://doi.org/10.1186/s12889-021-12091-y

Ida Peréa Monteiro, Flávia, C., João Paolo Bilibio, Pedro Sadi Monteiro, Giordana Campos

Braga, & Nitz, N. (2023). Prevalence of sexually transmissible infections in adolescents

treated in a family planning outpatient clinic for adolescents in the western Amazon.

Prevalence of Sexually Transmissible Infections in Adolescents Treated in a Family

Planning Outpatient Clinic for Adolescents in the Western Amazon, 18(6), e0287633–

e0287633. https://doi.org/10.1371/journal.pone.0287633

Karatana, O., Ergun, A., & Erol, S. (2022). The Effect of the Transtheoretical Model-Based

Healthy Youth Program on Sexual Health Knowledge and Behavior of College Women.

American Journal of Sexuality Education, 1–18.

https://doi.org/10.1080/15546128.2022.2086655

Tamara Nur Budiarti, Nisa Dewanti, Diana, M., & None Riesmiyatingdyah. (2024).

KNOWLEDGE, ATTITUDES, AND BEHAVIORS OF ADOLESCENTS IN

9

PREVENTING SEXUALLY TRANSMITTED DISEASES: A CORRELATIONAL

STUDY. Nurse & Health/Nurse and Health, 13(1), 156–162.

https://doi.org/10.36720/nhjk.v13i1.659

Velicer, W. F., Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Detailed

Overview of the Transtheoretical Model Material adapted and updated for this Website

from. https://www.lungenordination.at/TTM.pdf

Walensky, R. (2021). Morbidity and mortality weekly report sexually transmitted infections

treatment guidelines, 2021 centers for disease control and prevention MMWR editorial

and production staff (serials) MMWR editorial board.

https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf

10

1

Capstone Part I: PICOT Assignment

Ernesto Cisneros

Florida National University

MSN Capstone Project-DBX-DL01

Dr. Carmen Lazo

July 7, 2024

2

Sexually transmitted infections (STIs) are a substantial public health concern, particularly

among 13-19-year-olds. STIs disproportionately affect this group due to changing sexual habits,

insufficient sex education, and uneven access to prevention methods. Only 25% of sexually

active Americans are 15-24 years old, yet they account for half of new STI diagnoses (CDC,

2020). Adolescent STI prevention and management need targeted therapy. The project's

objective is to investigate how public STI prevention resources impact on knowledge and

attitudes of teens. The study will establish whether promoting testing, condoms and education

access promotes STI prevention. The research evaluates the knowledge and attitudes of teens

towards safer sexual activities in a bid to ascertain that preventive practices decrease the cases of

STI infection. The measures used are STI knowledge, preventive services use, and self-efficacy

in conducting safer sex practices. This study informs health practice and policy to reduce STIs in

young people and improves population health and quality of life for this vulnerable age group.

PICOT Question

In adolescents aged 13-19 years (P), how does access to publicly available STI

prevention resources (I) compared to limited access (C) influence knowledge and attitudes

towards STI prevention (O) over an 8-week period (T)?

Vulnerable Population

STIs are at a high frequency within the 13-19-year-old category due to many reasons,

including socioeconomic circumstantial determinants of health that affect their behavior and

access to care. One's class, education, and culture have much to do with the possibility of

acquiring an STI. Low-income teenagers may not be able to access appropriate knowledge for

comprehensive sex education and prevention if they are inferior, uninsured, or out of work. This

3

limitation can encourage deception and unsafe sexual practices, thereby heightening the risks of

acquiring STIs (Walensky, 2021).

Sexuality and STI norms in culture and society may potentially raise risk. Sexual health

is stigmatized in many communities, leading in inadequate knowledge and avoidance of

preventive treatment. This cultural climate makes it tougher for teens to make informed sexual

health decisions and get STI prevention. For instance, Hispanic and African American teens are

more affected by STIs than Caucasian teenagers (CDC, 2020).

Risk factors for STI prevention in adolescents include early sexual debut, inconsistent

condom use, having many sexual partners, and drug use. Considering the exposure and poor

prevention, teenagers engaged in such activities are more likely to develop STIs. Idaperéa

Monteiro et al. (2023) describe how inadequate parental supervision, peer influence, and media

exposure to risky behaviors may increase these risks, proving the impact of social and behavioral

determinants of adolescent sexual health.

These are issues that require interventions addressing socioeconomic determinants of

health that predispose an adolescent to STI acquisition. For this reason, a healthcare provider

may help an adolescent make informed decisions in matters concerning their sexual health by

participating in activities reducing socioeconomic disparities, funding relevant, culturally

appropriate education, and enhancing access to convenient and private care. This is of great

importance for the decrease of STIs among teenagers and the promotion of healthy, diverse

populations.

Literature Review

Recent peer-reviewed research shows several effective STI prevention techniques for

teenagers. Cannovo et al. (2024) stress the need for culturally sensitive and accessible sexual

4

health care and thorough STI testing and education for adolescents and young adults. Their

Macerata, Italy, research reveals that STI tests using swabs and blood are effective across age

groups and genders. Based on demographics and global comparisons, this approach diagnoses

prevalent STIs and offers prevention. Gogineni et al. (2021) stress STI screening and treatment

for U.S. teens. The MyVoice countrywide survey found that most teenagers and young adults are

willing to discuss STI care with their partners. It's possible to prioritize juvenile STI testing and

destigmatization.

Budiarti et al. (2024) point out that Indonesian teenagers' STD prevention knowledge,

attitudes, and behaviors are linked. Their correlational study demonstrates that comprehensive

sexual health education increases teens' STD awareness and prevention. This emphasizes the

necessity for sexual conduct education. These findings imply that teenagers should get

information, accessible testing, and culturally appropriate STI prevention. Community-based

outreach, school-based health education, and STI testing in routine healthcare have decreased

STI prevalence and improved long-term sexual health outcomes for adolescents globally.

.

Proposal

Education, resources, and community engagement are key to STI prevention for teens,

according to research. Using existing infrastructure, the effort will target schools and community

health centers for maximum impact. The intervention will standardize sexual health education

for 13-19-year-olds. STI prevention, contraception, and sexual decision-making will be covered.

Community nurses and school health educators will provide culturally sensitive and

developmentally appropriate programs. Teaching the software requires educational materials,

multimedia technologies, and educator training. Teachers, administrators, community leaders,

5

and healthcare professionals will be stakeholders, facilitating buy-in and support across

educational and healthcare contexts.

Community health centers will provide youth-friendly STI clinics to increase access.

These clinics will provide discreet STI testing, contraceptive advice, free condoms, and

educational brochures. Nurse practitioners and advanced practice nurses will staff these clinics,

assess, advise, and recommend additional therapy for adolescents. This initiative aims to reduce

teen stigma and ignorance about healthcare.

Intervention will be scheduled. Phase one curriculum development and stakeholder

involvement will last three months. Phase two includes six months of seminars and youth-

friendly clinics. Pre- and post-intervention surveys will evaluate adolescent STI prevention

knowledge, attitudes, and behaviors. Evaluation criteria include STI screening rates, condom use,

and sexual safety confidence.

This intervention is practical in advanced nursing because nurse practitioners may lead

educational activities, provide clinical care, and engage with community stakeholders. Clinical

skills and patient-centered approach may help nurses create trust and facilitate frank sexual

health discussions with teens. Working with school and community health initiatives promotes

sustainability and scalability, increasing adolescent health. This evidence-based intervention

helps teens make informed sexual health decisions by addressing STI prevention issues.

Theoretical Foundation

Stages of change Theory, more commonly known as the Transtheoretical Model (TTM),

supports behavior change, particularly in adolescent STI prevention. This notion defines

behavior modification as precontemplation, contemplation, preparation, action, and maintenance.

6

Information, beliefs, and environmental cues determine each stage's desire and motivation to

change behavior (Velicer et al., 1998).

TTM STI prevention in teens must address an assessment of readiness for behavior

change. Most teenagers are uninformed of the dangers of unprotected sexual conduct or ill-

informed, and most of them will be in either pre-contemplation or contemplation. As such, TTM

offers a chance to tailor teaching to the stages of teenagers. For instance, at precontemplation,

education can be provided on STIs and their effects while, at preparation and action, processes

for making decisions and how to carry out condom use and screening are offered (Karatana et al.,

2022).

Moreover, TTM stages denote the dynamic nature of adolescence and adolescent

behavior. Because of media, social interactions, and personal experience, adolescents' health

beliefs and practices related to sexuality may turn around overnight. TTM phases would help the

nurse and other healthcare professionals individualize their aid and advice with a teenager's

readiness for change. This sensitive population will need maintenance, checking, and

reinforcement that will sustain improvement in helpful responses without STI transmission. The

Transtheoretical Model enhances the theoretical and practical effectiveness of this intervention in

long-term behavior change regarding adolescent sexual health.

Conclusion

The public health has to address high rates of adolescent STIs, as they have long-term

effects on human well-being and healthcare systems. Based on the Transtheoretical Model, some

interventions provide teens with strategies for STI transmission prevention and upkeep of sexual

health. Quality sexual information, easily accessible health care, and community involvement

eliminate barriers to preventative care, promote informed decision-making, and hence may

7

decrease the cost of STI treatment and save a teen's life. Therefore, future studies should be

geared toward assessing the scalability, durability, long-term behavior change, and STI incidence

patterns of such therapies across communities and situations. Education-based initiatives that

make STI prevention increasingly common among teens around the globe should evolve in light

of cultural norms that are changing and other new requirements in health delivery.

8

References

Cannovo, N., Bianchini, E., Gironacci, L., Garbati, E., Di Prospero, F., Cingolani, M., Scendoni,

R., & Fedeli, P. (2024). Sexually Transmitted Infections in Adolescents and Young

Adults: A Cross Section of Public Health. International Journal of Environmental

Research and Public Health, 21(4), 501. https://doi.org/10.3390/ijerph21040501

CDC. (2020). Sexually transmitted disease surveillance 2020.

https://www.cdc.gov/std/statistics/2020/2020-SR-4-10-2023.pdf

Gogineni, V., Waselewski, M. E., Jamison, C. D., Bell, J. A., Hadler, N., Chaudhry, K. A.,

Chang, T., & Mmeje, O. O. (2021). The future of STI screening and treatment for youth:

a National Survey of youth perspectives and intentions. BMC Public Health, 21(1).

https://doi.org/10.1186/s12889-021-12091-y

Ida Peréa Monteiro, Flávia, C., João Paolo Bilibio, Pedro Sadi Monteiro, Giordana Campos

Braga, & Nitz, N. (2023). Prevalence of sexually transmissible infections in adolescents

treated in a family planning outpatient clinic for adolescents in the western Amazon.

Prevalence of Sexually Transmissible Infections in Adolescents Treated in a Family

Planning Outpatient Clinic for Adolescents in the Western Amazon, 18(6), e0287633–

e0287633. https://doi.org/10.1371/journal.pone.0287633

Karatana, O., Ergun, A., & Erol, S. (2022). The Effect of the Transtheoretical Model-Based

Healthy Youth Program on Sexual Health Knowledge and Behavior of College Women.

American Journal of Sexuality Education, 1–18.

https://doi.org/10.1080/15546128.2022.2086655

Tamara Nur Budiarti, Nisa Dewanti, Diana, M., & None Riesmiyatingdyah. (2024).

KNOWLEDGE, ATTITUDES, AND BEHAVIORS OF ADOLESCENTS IN

9

PREVENTING SEXUALLY TRANSMITTED DISEASES: A CORRELATIONAL

STUDY. Nurse & Health/Nurse and Health, 13(1), 156–162.

https://doi.org/10.36720/nhjk.v13i1.659

Velicer, W. F., Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Detailed

Overview of the Transtheoretical Model Material adapted and updated for this Website

from. https://www.lungenordination.at/TTM.pdf

Walensky, R. (2021). Morbidity and mortality weekly report sexually transmitted infections

treatment guidelines, 2021 centers for disease control and prevention MMWR editorial

and production staff (serials) MMWR editorial board.

https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf

10