Immediate Postpartum Contraception: Implementing and Evaluating Evidence-based Practice

项目摘要/摘要 候选人：米歇尔·H·莫尼兹，医学博士，理学硕士，产科妇科医生，初级保健医生 服务研究人员专注于改善生殖保健，特别是针对低收入者的保健 女人。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来 将循证生殖健康服务纳入常规临床实践。研究 背景：迫切需要改善获得循证避孕护理的机会 分娩，以降低意外怀孕率和改善生殖健康 结果。一种安全有效的策略是在产后立即提供长效 对感兴趣的妇女在出院前进行可逆避孕(IPLARC) 分娩。目前，在实际环境中提供IPLARC的差异很大，原因是 缺乏成功的执行方法和战略的循证指导 监控服务交付。研究目的：该提案的首要目标是设计、 评估和传播IPLARC服务的循证实施战略。这个 这项研究的具体目标是：1)定量评估当前基于医疗补助的索赔 衡量IPLARC供应的方法；2)成功的IPLARC的特征 实施经验和开发实施工具包；以及3)评估 该实施工具包在单一新环境中启动IPLARC的可行性。研究 计划：莫尼兹博士将使用当前基于索赔的算法来衡量IPLARC拨备和 将调查结果与医院自行报告的拨备率进行比较。她将深入、定性地进行 在5家成功实施IPLARC服务的医院和2个苦苦挣扎的地点进行研究 用IPLARC实现，从而开发出一个实现工具包。然后她将使用 在单一的新环境中评估实现工具包的可行性的混合方法 以便为未来的多中心研究提供信息。职业发展计划：莫尼兹博士将发展 以下方面的专门知识：1)以索赔为基础监测生殖健康服务；2)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提供支持；高级说教 课程工作；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名独立的 临床服务提供和旨在改进的政策方面的研究人员和国家领导者 低收入妇女的生殖健康结果。

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.