Date of Award

Spring 5-2024

Document Type

DNP Project

Project Team Faculty Member

Dr. Ashley Wittler

Project Team Faculty Member

Dr. Melissa Bogle


CycleBeads®, Standard Days Method®, teenage pregnancies, fertility awareness.


Research indicates that lack of reproductive knowledge, literacy & academic attrition, lack of educator support, poverty, religion, gender inequality, and decreased access to electronic devices contribute to high numbers of teenage pregnancies in Guatemala. Educating United States (U.S.) healthcare providers and Guatemalan volunteers/workers about fertility awareness using Standard Days Method® (SDM) and CycleBeads® has the potential to empower young Guatemalan women and encourage them to make independent, informed reproductive decisions. In December 2023, a quality improvement project was implemented in a Guatemalan rural health clinic. Likert scale questionnaires were utilized to assess knowledge and comfort levels regarding fertility awareness. Analysis of results focused on the views of U.S. healthcare providers who travel to Guatemala, along with locals who live and interact with young Guatemalan women needing further education. U.S. healthcare providers had minimal changes in scores between pre- and post-education questionnaires. Indigenous providers were unable to complete a post-education questionnaire due to time constraints during the global service trip. This lack of data prevented statistically significant conclusions regarding SDM and CycleBeads® use from being drawn. However, indigenous provider buy-in was evident via observation and social media pictures posted showing indigenous providers and other Guatemalan women teaching each other how to make CycleBeads®. The success of other research studies and the positive reception indicates teaching the SDM, specifically with CycleBeads®, is an educational trend that could continue being taught in other countries around the world.

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