Use of a Reproductive Life Planning Tool at the Pediatric Well-Baby Visit With Postpartum Women
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 129
- 试验地点
- 2
- 主要终点
- Change in receipt of primary care services - self report
研究概览
简要总结
Improved access to timely health care and contraception in the postpartum (PP) period is needed to reduce unintended pregnancies and help women achieve desired birth spacing. While the routine 6-week visit has historically been considered the place for women to discuss and receive contraception, many women, particularly low-income women, do not attend the postpartum visit. A novel approach to increasing receipt of PP care and contraception is the adoption of a reproductive life planning tool. Explorations of the use of a self-administered Reproductive Life Plan Tool (RLPT) by pediatricians in the context of the Well-Baby Visit (WBV) with postpartum mothers, holds great promise.
The objective of this study is to determine whether use of a simple self-administered Reproductive Life Plan Tool at the 2-month WBV increases the proportion of postpartum women receiving woman's health care and contraception at 6-months PP, compared to women not exposed to such an intervention. The two specific aims of the project are: 1) To determine if introducing a self-administered Reproductive Life Planning Tool (RLPT) with postpartum mothers during the 2-month WBV will increase the proportion of women receiving a well-woman primary care health visit by 6 months postpartum; and if introducing a self-administered Reproductive Life Planning Tool (RLPT) will increase utilization rates of contraception by 6 months postpartum. 2) To assess patient-, provider-, and systems-level barriers and facilitators to integrating a self-administered Reproductive Life Planning Tool (RLPT) designed to facilitate referral of postpartum women for primary well-woman care in the context of a pediatric clinic.
The investigators hypothesize that exposure to a self-administered RLPT combined with a conversation with a pediatrician during a 2-month WBV will increase use of well-woman primary health care during the postpartum period as well as receipt of contraception, by 6-months postpartum. If successful, the results of this study have great potential to inform clinical and public health practice to increase women's use of health care and contraception in the postpartum period.
详细描述
Specific Aims Aim I. To determine if introducing a self-administered Reproductive Life Planning Tool (RLPT) with postpartum mothers during the 2-month WBV will increase the proportion of women receiving a well-woman primary care health visit by 6 months postpartum.
Aim Ia. To determine if introducing a self-administered Reproductive Life Planning Tool (RLPT) with postpartum mothers during the 2-month WBV will increase utilization rates of contraception by 6 months postpartum.
Aim II: To assess the extent of system adoption as well as patient-, provider-, and systems-level barriers and facilitators to integrating a self-administered Reproductive Life Planning Tool designed to facilitate referral of postpartum women for primary well-woman care within the context of a pediatric clinic.
Study Design and Intervention This is a single-site system-level pilot study to measure the impact of a self-administered RLPT during the 2-month WBV on PP women's subsequent receipt of primary health care and contraception, compared to usual care. To facilitate women's uptake of a referral for well-woman primary care, mothers will be offered the opportunity to schedule a well-woman visit on the same day as their infant's next WBV or the first available visit if the participant needs more immediate care. This study will have two phases: phase 1 is enrollment of a control or baseline group, followed by a washout period; phase 2 is enrollment of the intervention group (intervention).
During phase 2 (intervention), the self-administered RLPT will be implemented in the Child and Youth Center (CYC, the general pediatric clinic) and the Primary Care Adolescent and Child Clinic (PCAC) at UIH with all PP women bringing infants for the 2-month WBV. The intervention leverages an existing system designed to screen all PP women (through 6-months) for depression.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Participant)
盲法说明
Because we are studying health behaviors, we cannot share the specific aims of the study with control group participants as this could bias behavior. The control group participants will be told that this is a study monitoring women's general health care experiences at UIH.
入排标准
- 年龄范围
- 15 Years 至 49 Years（Child, Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Postpartum women 15-49 years
- •Present with infant for a 2-month WBV at the UIC CYC or PCAC
- •Receive healthcare at UIC
- •Speak English or Spanish
排除标准
- •< 15 years or > 49 years of age
- •Receive healthcare outside the UIC system
- •Do not speak English or Spanish
结局指标
主要结局
Change in receipt of primary care services - self report
时间窗: 2-months and 6-months Postpartum (baseline and 4-months from baseline data collection)
Change in receipt of primary care services will be ascertained by self-report on the 2-month and 6-month Postpartum interview.
Change in receipt of primary care services - EMR review
时间窗: 2-months and 6-months Postpartum (baseline and 4-months from baseline data collection)
Change in receipt of primary care services will be ascertained by electronic medical record review at 2-months and 6-months Postpartum. Evidence of a visit from either source (self-report or EMR review) will be counted as receipt.
次要结局
- Contraception utilization(2-months and 6-months Postpartum (baseline and 4-months from baseline data collection))
- Participant feasibility and acceptability(The last half of Year 2)
- Provider feasibility and acceptability(The last half of Year 2)
研究者
Rachel N Caskey
Chief, Division of Academic Internal Medicine
University of Illinois at Chicago