Implementation science: Scaling a training intervention to include IUDs and implants in contraceptive services in primary care.
Building capacity for contraceptive services in primary care settings, including for intrauterine devices (IUDs) and implants, can help to broaden contraceptive access across the US. Following a randomized trial in family planning clinics, we brought a provider training intervention to other clinica...
| Publicado en: | Preventive Medicine Vol. 141 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Academic Press Inc.
Dec2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147202706&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147202706 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00917435 DP9 jtl: Preventive Medicine issn: 00917435 maglogo: N pubinfo: dt: Dec2020 vid: 141 pid: 735 pub: Academic Press Inc. place: Burlington, Massachusetts artinfo: ui: 147202706 147202706 NLM33096126 147202706 10.1016/j.ypmed.2020.106290 NLM33096126 147202706 ppct: 1 formats: tig: atl: Implementation science: Scaling a training intervention to include IUDs and implants in contraceptive services in primary care. aug: au: Harper, Cynthia C. Comfort, Alison B. Blum, Maya Rocca, Corinne H. McCulloch, Charles E. Rao, Lavanya Shah, Nishant Oquendo del Toro, Helen Goodman, Suzan affil: Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco School of Medicine, United States of America sug: subj: Contraceptive Agents Intrauterine Devices Human Primary Health Care Family Planning Female Comparative Studies Multicenter Studies Evaluation Research Validation Studies Funding Source Female ab: Building capacity for contraceptive services in primary care settings, including for intrauterine devices (IUDs) and implants, can help to broaden contraceptive access across the US. Following a randomized trial in family planning clinics, we brought a provider training intervention to other clinical settings including primary care in all regions. This implementation science study evaluates a national scale-up of a contraceptive training intervention to varied practice settings from 2013 to 2019 among 3216 clinic staff serving an estimated 1.6 million annual contraceptive patients. We measured providers' knowledge and clinical practice changes regarding IUDs and implants using survey data. We estimated the overall intervention effect, and its relative effectiveness in primary care settings, with generalized estimating equations for clustered data. Patient-centered counseling improved, along with comfort with method provision and removal. Provider knowledge increased (p < 0.001), as did evidence-based counseling for IUDs (aOR 3.3 95% CI 2.8-3.9) and implants (aOR 3.5, 95% CI 3.0-4.1), and clinician competency in copper and levonorgestrel IUDs (aORs 1.8-2.6 95% CIs 1.5-3.2) and implants (aOR 2.4 95% CI 2.0-2.9). While proficiency was lower initially in primary care, gains were significant and at times greater than in Planned Parenthood health clinics. This intervention was effectively scaled, including in primary care settings with limited prior experience with these methods. Recent changes to Title X family planning funding rules exclude several large family planning providers, shifting greater responsibility to primary care and other settings. Scaling effective contraceptive interventions is one way to ensure capacity to offer patients full contraceptive services. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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