Center for Applied Research and Evaluation in Women's Health, Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN, United States.
Center for Applied Research and Evaluation in Women's Health, Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN, United States.
Contraception. 2021 Aug;104(2):155-158. doi: 10.1016/j.contraception.2021.04.016. Epub 2021 Apr 22.
Capacity building and training to improve contraceptive care is essential for patient-centered care and reproductive autonomy. This study assessed the feasibility of translating the knowledge and skills gained from contraception trainings into improvements in practice.
Participants completed surveys following contraceptive care trainings provided to family planning clinic and hospital obstetric providers and staff as a part of the Choose Well contraceptive access initiative in South Carolina. Surveys assessed participants' intent to change their practice post-training and anticipated barriers to implementing change. A mixed-methods approach was utilized including descriptive analysis of Likert scale responses and thematic content analysis to synthesize open-ended, qualitative responses.
Data were collected from 160 contraceptive training sessions provided to 4814 clinical and administrative staff between 2017 and 2019. Post-training surveys were completed by 3464 participants (72%), and of these, 2978 answered questions related to the study outcomes. Most respondents (n = 2390; 80.7%) indicated intent to change their practice and 35.5% (n = 1044) anticipated barriers to implementing intended changes. Across all training categories, organizational factors (time constraints, policies and practices, infrastructure/resources) were the most frequently perceived barrier to improving contraceptive services. Structural factors related to cost for patients were also identified as barriers to IUD and implant provision.
The trainings were successful in influencing family planning staff and providers' intent to improve their contraceptive practices, yet some anticipated barriers in translating training into practice. Improvements in organizational and structural policies are critical to realizing the benefits of trainings in advancing quality contraceptive care.
In addition to training, coordinated efforts to address organizational practices and resources, coupled with system-level policy changes are essential to facilitate the delivery and sustainability of patient-centered contraceptive care.
能力建设和培训对于以患者为中心的护理和生殖自主权至关重要。本研究评估了将避孕培训中获得的知识和技能转化为实践改进的可行性。
参与者在南卡罗来纳州选择生育力避孕获取倡议中完成了避孕护理培训后，完成了调查。这些培训是为计划生育诊所和医院产科提供者和工作人员提供的。调查评估了参与者培训后改变实践的意愿以及实施变革的预期障碍。采用混合方法，包括对李克特量表反应的描述性分析和对开放式定性反应的主题内容分析。
在 2017 年至 2019 年间，共为 4814 名临床和行政人员提供了 160 次避孕培训课程。有 3464 名参与者（72%）完成了培训后调查，其中 2978 名回答了与研究结果相关的问题。大多数受访者（n=2390；80.7%）表示有意改变他们的实践，35.5%（n=1044）预期实施预期变化的障碍。在所有培训类别中，组织因素（时间限制、政策和实践、基础设施/资源）是改善避孕服务最常被认为的障碍。与患者成本相关的结构性因素也被确定为提供宫内节育器和植入物的障碍。
培训成功地影响了计划生育工作人员和提供者改善避孕实践的意愿，但一些预期的培训转化为实践的障碍。改善组织和结构性政策对于实现培训在提高优质避孕护理方面的益处至关重要。
除了培训外，协调努力解决组织实践和资源问题，以及系统层面的政策变化，对于促进以患者为中心的避孕护理的提供和可持续性至关重要。
