Immediate Postpartum Contraception: Implementing and Evaluating Evidence-based Practice

项目概要/摘要 候选人： Michelle H. Moniz，医学博士、理学硕士，是一名妇产科医生和初级健康专家 服务研究人员专注于改善生殖保健，特别是低收入人群 妇女。 Moniz 博士的长期职业目标是成为一名独立的医师研究员 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：迫切需要改善获得基于证据的避孕护理的机会 分娩，以降低意外怀孕率并改善生殖健康 结果。一种安全、有效的策略是立即提供产后长效药物 可逆避孕 (IPLARC) 向有兴趣的女性在出院前提供 分娩。目前，由于以下原因，实际环境中 IPLARC 的提供存在很大差异： 缺乏关于成功实施方法和战略的循证指导 监控服务交付。研究目标：该提案的总体目标是设计、 评估和传播 IPLARC 服务的循证实施策略。的 研究的具体目标是： 1) 定量评估当前基于医疗补助索赔的情况 衡量 IPLARC 提供的方法； 2) 成功 IPLARC 的特征 实施经验并开发实施工具包； 3) 评估 该实施工具包在单一新设置中启动 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 的提供和 将调查结果与医院自我报告的供应率进行比较。她将进行深入、定性的 在 5 家已成功实施 IPLARC 服务的医院和 2 家陷入困境的医院进行研究 与 IPLARC 实施一起，以开发实施工具包。然后她会使用 混合方法来评估实施工具包在单一新环境中的可行性， 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 专业知识： 1) 基于索赔的生殖健康服务监测； 2）实施 科学框架； 3）混合方法； 4) 负责任地进行研究。莫尼兹博士的培训 将得到经验丰富的跨学科导师的支持；先进的教学 课程作业；以及参加研究和职业发展会议/研讨会 理想的培训环境。该奖项将使莫尼兹博士成为一名独立的 临床服务提供和政策旨在改善的研究者和国家领导者 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.