Pregnancy Related
Conditions
Keywords
contraception, long-acting reversible contraception, postpartum, toolkit, implementation, feasibility
Brief summary
The objective of this study is to test and disseminate tools that drive successful immediate postpartum Long-Acting Reversible Contraception (LARC) implementation. The long-term goal is to reduce unintended pregnancy soon after childbirth by increasing access to immediate postpartum LARC for women who desire it.
Detailed description
Based on previous work, the investigators have generated a toolkit to guide the integration of immediate postpartum LARC services into widespread clinical practice. In the proposed work, this toolkit will be used to initiate immediate postpartum LARC services in a single site with low baseline immediate postpartum LARC uptake (Michigan Medicine). The investigators will conduct a feasibility study using mixed methods to assess acceptability and appropriateness of toolkit items; patient experience of care; immediate postpartum LARC utilization rate; and prenatal contraceptive counseling rate.
Interventions
OTHERImplementation Toolkit
Post-implementation patients and providers will be assessed after the implementation toolkit has been used to improve service delivery at the study site.
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
University of Michigan
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female (patients) * Pregnant (patients) * Receiving obstetrical care at Michigan Medicine (patients) * L&D provider at Michigan Medicine (providers)
Exclusion criteria
* non-English speaking * unable to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient experience of care | Surveys will be collected from pregnant or postpartum women, during the 6-12 months after implementation of a new protocol for peripartum contraceptive care | Patient online surveys about their experience of care during prenatal visits, hospital stay, or postpartum office visit |
| Acceptability of care process - patients | Surveys will be collected from pregnant or postpartum women, during the 6-12 months after implementation of a new protocol for peripartum contraceptive care | Online survey assessing experience of care, acceptability and appropriateness of implementation tools |
| Appropriateness of care process - patients | Surveys will be collected from pregnant or postpartum women, during the 6-12 months after implementation of a new protocol for peripartum contraceptive care | Online survey assessing experience of care, acceptability and appropriateness of implementation tools |
| Acceptability of implementation process - study site maternity care providers | Surveys will be collected during the 6-12 months after implementation of a new protocol for peripartum contraceptive care | Online survey assessing overall experience of care delivery, acceptability and appropriateness of implementation tools |
| Appropriateness of implementation process - study site maternity care providers | Surveys will be collected during the 6-12 months after implementation of a new protocol for peripartum contraceptive care | Online survey assessing overall experience of care delivery, acceptability and appropriateness of implementation tools |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability of implementation toolkit items - patients | Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care | 30-minute follow-up in-person interview of subgroup of patients who completed surveys |
| Immediate postpartum LARC provision rate | Measured monthly, up to 24 months after toolkit implementation | Proportion of delivered patients with documentation of preference for immediate postpartum LARC who receive a LARC device |
| Appropriateness of implementation toolkit items - patients | Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care | 30-minute follow-up in-person interview of subgroup of patients who completed surveys |
| Acceptability of implementation toolkit items - providers | Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care | 30-minute follow-up in-person interview of subgroup of providers who completed survey |
| Appropriateness of implementation toolkit items - providers | Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care | 30-minute follow-up in-person interview of subgroup of providers who completed survey |
| Perinatal contraceptive counseling rate | Measured monthly, up to 24 months after toolkit implementation | Proportion of delivered patients with documentation of prenatal counseling about postpartum contraception |
Countries
United States
Outcome results
None listed