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| Name | Class |
|---|---|
| Agency for Healthcare Research and Quality (AHRQ) | FED |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-Implementation Patients | Enrolled patients will take online surveys following a prenatal or a postpartum visit. | ||
| Post-Implementation Patients | All enrolled patients will take online surveys following a prenatal or a postpartum visit. A subset will be interviewed after the postpartum survey. |
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| Post-Implementation Providers | All enrolled providers will take online surveys at 6-12 months after program implementation, and a subset will be interviewed. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Implementation Toolkit | Other | Post-implementation patients and providers will be assessed after the implementation toolkit has been used to improve service delivery at the study site. |
| Measure | Description | Time Frame |
|---|---|---|
| Patient experience of care | Patient online surveys about their experience of care during prenatal visits, hospital stay, or postpartum office visit | Surveys will be collected from pregnant or postpartum women, during the 6-12 months after implementation of a new protocol for peripartum contraceptive care |
| Acceptability of care process - patients | Online survey assessing experience of care, acceptability and appropriateness of implementation tools | Surveys will be collected from pregnant or postpartum women, during the 6-12 months after implementation of a new protocol for peripartum contraceptive care |
| Appropriateness of care process - patients | Online survey assessing experience of care, acceptability and appropriateness of implementation tools | Surveys will be collected from pregnant or postpartum women, during the 6-12 months after implementation of a new protocol for peripartum contraceptive care |
| Acceptability of implementation process - study site maternity care providers | Online survey assessing overall experience of care delivery, acceptability and appropriateness of implementation tools | Surveys will be collected during the 6-12 months after implementation of a new protocol for peripartum contraceptive care |
| Appropriateness of implementation process - study site maternity care providers | Online survey assessing overall experience of care delivery, acceptability and appropriateness of implementation tools | Surveys will be collected during the 6-12 months after implementation of a new protocol for peripartum contraceptive care |
| Measure | Description | Time Frame |
|---|---|---|
| Acceptability of implementation toolkit items - patients | 30-minute follow-up in-person interview of subgroup of patients who completed surveys | Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care |
| Appropriateness of implementation toolkit items - patients |
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Inclusion Criteria:
Exclusion Criteria:
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Study population includes women receiving prenatal care and maternity providers working at the study site. The patient populations includes approximately 5000 women annually. The provider population includes approximately 400 maternity providers.
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| Name | Affiliation | Role |
|---|---|---|
| Michelle H. Moniz, MD, MSc | University of Michigan | Principal Investigator |
| Vanessa K. Dalton, MD, MPH | University of Michigan | Principal Investigator |
| Michelle Heisler, MD, MPH | University of Michigan | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Michigan Medicine | Ann Arbor | Michigan | 48109 | United States |
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30-minute follow-up in-person interview of subgroup of patients who completed surveys |
| Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care |
| Acceptability of implementation toolkit items - providers | 30-minute follow-up in-person interview of subgroup of providers who completed survey | Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care |
| Appropriateness of implementation toolkit items - providers | 30-minute follow-up in-person interview of subgroup of providers who completed survey | Interviews will take place after the survey is completed, during the 6-18 months after implementation of a new protocol for peripartum contraceptive care |
| Perinatal contraceptive counseling rate | Proportion of delivered patients with documentation of prenatal counseling about postpartum contraception | Measured monthly, up to 24 months after toolkit implementation |
| Immediate postpartum LARC provision rate | Proportion of delivered patients with documentation of preference for immediate postpartum LARC who receive a LARC device | Measured monthly, up to 24 months after toolkit implementation |