Evaluating the impact of Marie Stopes International's digital family planning counselling application on the uptake of long-acting and permanent methods of contraception in Vietnam and Ethiopia: a study protocol for a multi-country cluster randomised controlled trial.
Evaluating the impact of Marie Stopes International's digital family planning counselling application on the uptake of long-acting and permanent methods of contraception in Vietnam and Ethiopia: a study protocol for a multi-country cluster randomised controlled trial.
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DOI：
10.1186/s13063-018-2815-0
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发表时间：
2018-08-04
期刊：
影响因子：
2.5
通讯作者：
Robinson E
中科院分区：
文献类型：
--
作者：
Bates LA;Hicks JP;Walley J;Robinson E
在资源匮乏的环境中保持计划生育咨询服务的质量是一项挑战。工作辅助工具可以帮助提供者提供更准确和针对客户的建议，但需要提供者有效和一致地使用它们。玛丽·斯托普斯国际组织（MSI）设计了基于平板电脑的数字咨询应用程序（DCA），该应用程序可提供结构化、支持性、针对具体客户和公正的计划生育咨询。我们假设，对客户的生育意愿、医疗资格和偏好进行系统的探索，将增加他们对长效和永久避孕方法（LAPMs）的采用。我们将在埃塞俄比亚（24个）和越南（11个）的所有MSI诊所（集群）中进行一项双臂、平行、集群随机对照试验，将18个诊所随机分配到干预组，17个随机分配到对照组。干预提供者将参加为期两天的DCA使用培训计划，并在计划生育咨询课程中使用DCA。医疗服务提供者将像以前一样为客户提供咨询。我们的目标是每个诊所招募75名接受过FP咨询的客户（共2625名），通过两次电话访谈进行随访，最初在2天内，然后在4个月内。主要结果定义为报告在FP咨询后选择LAPM的客户比例，包括转换者（从使用任何其他FP方法转换的FP咨询客户）和采用者（采用任何FP方法的FP咨询客户以前没有使用过）。我们还将在初始随访时收集次要结果（包括提供者推荐LAPM的客户比例以及客户体验和满意度的一系列指标）和4个月随访时（包括不同FP方法类型的继续率的一系列指标）。在干预组中，我们还将进行混合方法抽样，以评估提供者如何使用DCA（使用提供者与客户互动的观察性调查），并了解使用者接受和提供基于DCA的计划生育咨询的经验（通过深入访谈）。本试验将提供关于卫生工作者使用DCA提供FP咨询的可行性和可接受性的新信息，并提供关于其在低资源环境中增加LAPM吸收的有效性的有力证据。ISRCTN，ISRCTN 11040557。于二零一七年三月二日注册（追溯注册）。本文的在线版本（10.1186/s13063-018-2815-0）包含补充材料，可供授权用户使用。
Maintaining quality of care in family planning (FP) counselling in low-resource settings is challenging. Job aids can help providers give more accurate and client-specific advice but require a provider to use them effectively and consistently. Marie Stopes International (MSI) have designed the tablet-computer based Digital Counselling Application (DCA), which prompts structured, supportive, client-specific and unbiased FP counselling. We hypothesise that a systematic exploration of clients’ fertility intentions, medical eligibility and preferences will increase their uptake of long acting and permanent methods of contraception (LAPMs). We will conduct a two-armed, parallel, cluster randomised control trial across all MSI clinics (clusters) in Ethiopia (24) and Vietnam (11), randomising 18 clinics to the intervention group and 17 to the control group. Intervention providers will attend a two-day DCA-use training programme, and use DCA in their FP counselling sessions. Usual care providers will counsel clients as before. We aim to recruit 75 clients who have had FP counselling per clinic (2625 total), following them up via two telephone interviews, initially within 2 days and then at 4 months. The primary outcome is defined as the proportion of clients who report choosing a LAPM following FP counselling and will include switchers (FP counselling clients who switch from using any other FP method) and adopters (FP counselling clients who adopt any FP method having not previously been using one). We will also collect secondary outcomes at the initial follow-up (including the proportion of clients reporting being recommended a LAPM by a provider and a range of measures of client experience and satisfaction) and at the 4-month follow-up (including a range of measures of continuation rates for different FP method types). In the intervention arm, we will also conduct mixed-methods sampling to assess how providers use DCA (using an observational survey of provider–client interactions), and understand users’ experiences of receiving and giving DCA-based FP counselling (through in-depth interviews). This trial will provide novel information on the feasibility and acceptability of health worker delivered FP counselling using DCA, with robust evidence on its effectiveness at increasing the uptake of LAPMs in low-resource settings. ISRCTN, ISRCTN11040557. Registered on 2 March 2017 (retrospectively registered). The online version of this article (10.1186/s13063-018-2815-0) contains supplementary material, which is available to authorized users.
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