Immediate Postpartum Contraception: Implementing and Evaluating Evidence-based Practice

项目总结/摘要 候选人：米歇尔·H。莫尼兹，医学博士，理学硕士是一个产科医生妇科医生和初级卫生 服务研究人员侧重于改善生殖保健，特别是低收入者的生殖保健 妇女莫尼兹博士的长期职业目标是成为一名独立的医生调查员 通过制定、实施、评估和传播有效的战略， 将循证生殖健康服务纳入常规临床实践。研究 背景：在发生以下情况后，迫切需要改善获得循证避孕护理的机会 生育，以减少意外怀孕率和改善生殖健康 结果。一个安全有效的策略是立即提供产后长效 可逆性避孕（IPLARC），以感兴趣的妇女之前，他们离开医院后， 分娩目前，在现实世界的设置中提供IPLARC存在很大的差异，这是由于 缺乏关于成功实施方法和战略的循证指导， 监测服务提供情况。研究目标：本提案的总体目标是设计， 评价和传播国际地方政府援助研究所服务的循证执行战略。的 研究的具体目标是：1）量化评估目前医疗补助索赔为基础的 用于测量IPLARC提供的方法; 2）表征成功的IPLARC 实施经验，并开发一个实施工具包; 3）评估 这一执行工具包在单一新环境中启动IPLARC的可行性。研究 计划：Moniz博士将使用当前基于索赔的算法来衡量IPLARC供应， 将调查结果与医院自我报告的提供率进行比较。她将进行深入，定性 在5家已成功实施IPLARC服务的医院和2家正在挣扎的研究中心进行的研究 与IPLARC的实施，以开发一个实施工具包。然后她会用 混合方法来评估实施工具包在单一新环境中的可行性， 为将来的多中心研究提供信息。职业发展计划：Moniz博士将发展 具备以下方面的专门知识：⑴根据要求监测生殖健康服务; ⑵执行 科学框架; 3）混合方法; 4）负责任的研究行为。莫尼兹博士的训练 将由经验丰富的跨学科导师支持;先进的教学 课程;以及参加研究和职业发展会议/研讨会， 理想的训练环境。这一奖项将使莫尼兹博士成为一个独立的 临床服务提供和政策方面的研究者和国家领导者， 低收入妇女的生殖健康成果。

Project Summary/Abstract Candidate: Michelle H. Moniz, MD, MSc is an obstetrician gynecologist and junior health services researcher focused on improving reproductive health care, especially for low-income women. Dr. Moniz's long-term career goal is to become an independent physician-investigator through development, implementation, evaluation, and dissemination of effective strategies to integrate evidence-based reproductive health services into routine clinical practice. Research Context: There is a critical need to improve access to evidence-based contraceptive care after childbirth, in order to decrease unintended pregnancy rates and improve reproductive health outcomes. One safe, effective strategy is to provide immediate postpartum long-acting reversible contraception (IPLARC) to interested women before they leave the hospital after childbirth. Currently, there is wide variation in provision of IPLARC in real-world settings due to a dearth of evidence-based guidance on successful implementation methods and strategies for monitoring service delivery. Research Aims: The overarching goal of this proposal is to design, evaluate and disseminate evidence-based implementation strategies for IPLARC services. The study's specific aims are to: 1) Quantitatively evaluate current Medicaid claims-based approaches for measuring IPLARC provision; 2) Characterize successful IPLARC implementation experiences and develop an implementation toolkit; and 3) Evaluate the feasibility of this implementation toolkit for initiating IPLARC in a single new setting. Research Plan: Dr. Moniz will use current claims-based algorithms to measure IPLARC provision and compare findings to hospitals' self-reported provision rates. She will conduct in depth, qualitative study at 5 hospitals that have successfully implemented IPLARC services and 2 sites struggling with IPLARC implementation, in order to develop an implementation toolkit. She will then use mixed methods to evaluate the implementation toolkit's feasibility in a single new setting, in order to inform a future multi-center study. Career Development Plan: Dr. Moniz will develop expertise in: 1) claims-based monitoring of reproductive health services; 2) implementation science frameworks; 3) mixed methods; 4) responsible conduct of research. Dr. Moniz's training will be supported by highly experienced, interdisciplinary mentors; advanced didactic coursework; and participation in research and career development meetings/seminars within an ideal training environment. This award will enable Dr. Moniz to become an independent investigator and national leader in clinical service delivery and policies designed to improve reproductive health outcomes for low-income women.