<p>The United States Medical Eligibility Criteria and Selected Practice Recommendations for Contraceptive Use are clinical practice guidelines that can help healthcare providers deliver high quality contraceptive care. Little is known about how to best implement these guidelines, particularly in Title X clinics, a critical source of family planning services for low-income individuals. This study aimed to identify multilevel factors important to the implementation of these guidelines in Georgia Title X settings. We conducted semi-structured interviews with 20 Georgia Title X providers in 2023. Guided by the updated Consolidated Framework for Implementation Research, we analyzed transcripts using rapid and thematic qualitative analysis techniques in Google Sheets and Dedoose, respectively. We identified several relevant constructs in all five framework domains, with most findings related to constructs in the <i>Innovation</i>,<i> Individuals</i>, and <i>Inner Setting</i> domains. Examples include the guidelines’ perceived low <i>Complexity</i> and high <i>Relative Advantage</i> (<i>Innovation</i>); some providers’ dual role as <i>Implementation Facilitators</i> and <i>Innovation Recipients</i> (<i>Individuals</i>); the desire for increased <i>Access to Knowledge and Information</i> about the guidelines (<i>Inner Setting</i>); strong <i>Partnerships and Connections</i> between Georgia Title X clinics and local health organizations (<i>Outer Setting</i>); and the reported lack of processes for <i>Assessing Needs</i> of <i>Innovation Recipients</i> (<i>Implementation Process</i>). We identified key gaps and developed tailored recommendations for the implementation of these guidelines among Georgia Title X settings. Implementation efforts should align with providers’ needs, leverage existing resources, and use targeted communication.</p>

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Applying the Consolidated Framework for Implementation Research to Contraception Guidelines Implementation in Georgia Title X Settings

  • Sophia C. Garbarino,
  • Elizabeth Reisinger Walker,
  • Peyton Williams,
  • Melissa J. Kottke,
  • Jessica M. Sales

摘要

The United States Medical Eligibility Criteria and Selected Practice Recommendations for Contraceptive Use are clinical practice guidelines that can help healthcare providers deliver high quality contraceptive care. Little is known about how to best implement these guidelines, particularly in Title X clinics, a critical source of family planning services for low-income individuals. This study aimed to identify multilevel factors important to the implementation of these guidelines in Georgia Title X settings. We conducted semi-structured interviews with 20 Georgia Title X providers in 2023. Guided by the updated Consolidated Framework for Implementation Research, we analyzed transcripts using rapid and thematic qualitative analysis techniques in Google Sheets and Dedoose, respectively. We identified several relevant constructs in all five framework domains, with most findings related to constructs in the Innovation, Individuals, and Inner Setting domains. Examples include the guidelines’ perceived low Complexity and high Relative Advantage (Innovation); some providers’ dual role as Implementation Facilitators and Innovation Recipients (Individuals); the desire for increased Access to Knowledge and Information about the guidelines (Inner Setting); strong Partnerships and Connections between Georgia Title X clinics and local health organizations (Outer Setting); and the reported lack of processes for Assessing Needs of Innovation Recipients (Implementation Process). We identified key gaps and developed tailored recommendations for the implementation of these guidelines among Georgia Title X settings. Implementation efforts should align with providers’ needs, leverage existing resources, and use targeted communication.