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Champions of contraceptive care: Lessons learned from a statewide contraceptive access program
Katharine O White1, Natasha M Lerner2, Lillian W Acton2
1Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States; Boston Medical Center, Boston, MA, United States.
Objective:
The Partners in Contraceptive Choice and Knowledge (PICCK) program encouraged improvements in contraceptive access and quality for Massachusetts hospital-based providers. The program employed a champion model, working with individuals at each partner hospital who were committed to implementing a customized version of the PICCK program. We present the facilitators and barriers to uptake of the customized PICCK initiative.
Study Design:
We conducted 17 semi-structured interviews involving 26 champions from 13 different PICCK partner hospitals. Researchers who were not involved with overall PICCK program implementation conducted the interviews with a guide based on the Consolidated Framework on Implementation Research (CFIR). Interviews were held via telec onferencing, professionally transcribed, and coded independently by three researchers. We used a combination of inductive and deductive thematic analysis.
Results:
We identified facilitators and barriers that represented constructs from all 5 CFIR domains. Additionally, we explored four emergent themes: 1) dynamic interplay between internal and external factors; 2) champion self-efficacy to make change; 3) importance of alignment between the program and the hospital; and 4) heterogeneity of willingness to change.
Conclusion:
PICCK was an innovative public health program that utilized evidence-based strategies to improve contraceptive quality and access. Interviews with the program champions revealed advantages to using the champion approach, as well as lessons learned that can be used for future statewide initiatives that strive to expand contraceptive access. While PICCK was primarily a hospital-based initiative, findings may be applicable to other clinical settings or access programs that employ a similar champion model.
Implications:
A champion model can be an effective way to combine external program resources with institutional knowledge, relationships, and motivation toward implementation of a contraceptive access initiative.
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