Process evaluation of a task-shifting strategy in hormonal contraception: does training translate into practice?

Area of Science:

• Reproductive Health
• Nursing Practice
• Public Health Policy

Background:

• Quebec faces physician shortages and reduced access to prescription contraceptives.
• A 2007 task-shifting initiative trained nurses to initiate hormonal contraception for healthy women.
• This aimed to improve access to reproductive health services.

Purpose of the Study:

• To determine the proportion of trained nurses involved in prescribing hormonal contraception.
• To identify factors associated with nurses' participation in this practice.

Main Methods:

• Cross-sectional study surveying nurses trained in hormonal contraception in Quebec.
• Participants were registered with the College of Nurses of Quebec and employed in the Quebec Health System.
• Data collected via postal or electronic survey.

Main Results:

• 57.3% of 745 respondents were involved in the new practice.
• Adoption of the Collaborative Agreement in Hormonal Contraception by health organizations was the primary determinant.
• Other factors included earlier training, permanent employment, youth clinic work, and rural/remote practice settings.

Conclusions:

• Formalizing nurse training in hormonal contraception is recommended, integrating it into all nursing education levels.
• Implementation in other settings like family medicine groups is encouraged.
• This strategy can enhance contraceptive access in Quebec.