Linking Inter-professional Newborn and Contraception Care (LINCC) Trial - A Novel Approach to Postpartum Contraception Provision at the Well-Baby Visit

将跨专业新生儿与避孕护理 (LINCC) 试验联系起来 - 在婴儿健康检查中提供产后避孕的新方法

• 批准号: 10363696
• 负责人: RACHEL CASKEY
• 金额: $ 39.59万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-21 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10363696
• 关键词: Academic Medical Centers; Address; Administrator; Affect; Anemia; Caring; Child; Client; Clinic; Community Health; Consolidated Framework for Implementation Research; Contraceptive Agents; Contraceptive methods; Development; Electronic Health Record; Family; Geography; Goals; Health; Improve Access; Infant; Infant Care; Intervention; Interview; Link; Low income; Maternal Health; Methods; Minority Women; Modeling; Mothers; Neighborhood Health Center; Newborn Infant; Outcome; Patients; Postpartum Period; Postpartum Women; Pre-Eclampsia; Pregnancy; Pregnancy Interval; Premature Birth; Provider; Public Health; Randomized; Reach Effectiveness Adoption Implementation and Maintenance; Readiness; Reporting; Rural; Schedule; Services; Sex Behavior; Site; System; Time; Use Effectiveness; Visit; Vulnerable Populations; Woman; Women' s Group; Work; base; clinical care; clinical practice; community based research; compare effectiveness; design; effectiveness evaluation; effectiveness implementation study; experience; high risk; implementation evaluation; implementation framework; implementation intervention; implementation process; improved; improved outcome; insight; instrument; novel; novel strategies; organizational readiness; patient oriented; post intervention; postpartum care; postpartum contraception; prevent; unintended pregnancy; uptake

PROJECT SUMMARY/ABSTRACT Pregnancies conceived within 18 months of a prior delivery (termed short inter-pregnancy interval [IPI]) place mothers and infants at high risk for poor health outcomes including pre-eclampsia, anemia, and preterm birth. Despite these negative health consequences, nearly one third of women experience a short IPI, highlighting a significant public health problem in the U.S. A critical approach to preventing short IPIs is to provide postpartum (PP) women with timely access to contraception. The current standard clinical practice is to have women return six weeks after delivery for a postpartum visit, at which time contraceptive needs are addressed. However, many women resume sexual activity prior to six weeks PP, and many women, particularly low-income minority women, do not present for this visit. Low rates of postpartum contraception uptake leave women vulnerable to an unplanned pregnancy and significant negative health consequences. Thus, there is an urgent need for alternative approaches to increase timely access to PP contraception to improve outcomes for women and children. The proposed study aims to: (1) develop a comprehensive implementation plan to link PP contraception and newborn care through co-scheduling visits in community health centers (CHC) and (2) use an effectiveness- implementation hybrid design to evaluate this novel system-level approach to linking maternal and newborn care at CHCs served by our partner organization, AllianceChicago. Lastly, we aim to: (3) assess implementation of linked PP contraception and newborn care and report on key barriers and facilitators related to successful implementation of the intervention. Increasing access to timely contraception is a promising strategy to help women plan their families and, in turn, reduce the poor health sequela associated with short IPI pregnancies. The long-term impact of this study is to reduce negative health outcomes among PP women and infants by increasing access to patient-oriented PP contraceptive care. Findings may provide evidence supporting a paradigm shift for linked PP care and identify important insights to facilitate successful implementation of this model of care in CHCs across the nation.

项目总结/文摘