An innovative sequential mixed-methods approach to evaluating clinician acceptability during implementation of a...

Area of Science:

• Implementation Science
• Maternal Health
• Healthcare Quality Improvement

Background:

• Clinician acceptability is crucial for successful implementation of healthcare interventions.
• The Acceptability of Intervention Measure (AIM) has limitations due to positive skewness.
• Standardizing labor induction is a key area for improving care delivery.

Purpose of the Study:

• To evaluate clinician acceptability of a standardized labor induction protocol.
• To enhance the interpretability of the AIM using a mixed-methods approach.
• To identify strategies for improving acceptability in implementation research.

Main Methods:

• An explanatory sequential mixed-methods design was employed.
• The Acceptability of Intervention Measure (AIM) was administered to 104 clinicians.
• Qualitative interviews were conducted with clinicians in high and low acceptability groups.

Main Results:

• Clinicians generally supported induction standardization for reducing variability and improving care.
• Low acceptability was linked to concerns about flexibility and patient uniqueness.
• Negative sentiment was associated with labor medicalization and perceived patient "bulldozing ".

Conclusions:

• A mixed-methods approach effectively characterized clinician acceptability of induction standardization.
• Implementation strategies, including clinician education and patient involvement, can address acceptability barriers.
• Findings inform future multi-site implementation efforts in maternal health.