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Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool

BACKGROUND: One Key Question(®) (OKQ) is a tool that embeds a patient-centered screening into routine visits with the goal of making pregnancy intention screening universal, but widespread implementation has not yet been adopted. We aimed to explore the barriers and facilitators of OKQ implementatio...

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Autores principales: Ferketa, Meron, Schueler, Kellie, Song, Bonnie, Carlock, Francesca, Stulberg, Debra B., White VanGompel, Emily
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994428/
https://www.ncbi.nlm.nih.gov/pubmed/35415707
http://dx.doi.org/10.1089/whr.2021.0100
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author Ferketa, Meron
Schueler, Kellie
Song, Bonnie
Carlock, Francesca
Stulberg, Debra B.
White VanGompel, Emily
author_facet Ferketa, Meron
Schueler, Kellie
Song, Bonnie
Carlock, Francesca
Stulberg, Debra B.
White VanGompel, Emily
author_sort Ferketa, Meron
collection PubMed
description BACKGROUND: One Key Question(®) (OKQ) is a tool that embeds a patient-centered screening into routine visits with the goal of making pregnancy intention screening universal, but widespread implementation has not yet been adopted. We aimed to explore the barriers and facilitators of OKQ implementation to better understand how to best implement the tool across different settings. METHODS: We invited staff and clinicians from one obstetrics and gynecology clinic and one family medicine clinic, which previously implemented OKQ, to complete surveys and qualitative interviews about their experiences with the tool. The interview guide and thematic analysis of the interview transcripts were informed by the Consolidated Framework for Implementation Research (CFIR). MAIN FINDINGS: Major facilitators of OKQ implementation are the simplicity of the tool, engagement of clinic leadership, and compatibility between the perceived goals of the tool and those of practice staff and clinicians. Although participants indicated that OKQ had a minimal impact on clinic workflow during its implementation, preimplementation time concerns were a major barrier to implementation in both clinics. Barriers seen in the family medicine practice included OKQ distracting from the visit agenda, and concerns about the OKQ gold standard protocol of screening each patient at every visit. Participants even suggested asking OKQ only during annual check-up appointments. CONCLUSIONS: The perceived alignment between the tool's goals and those of clinic stakeholders was an important facilitator of OKQ implementation success. However, characteristics of the clinic setting, such as competing medical priorities and time constraints, influenced initial attitudes toward the feasibility of the intervention. Clinical Trial Registration Number: NCT03947788
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spelling pubmed-89944282022-04-11 Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool Ferketa, Meron Schueler, Kellie Song, Bonnie Carlock, Francesca Stulberg, Debra B. White VanGompel, Emily Womens Health Rep (New Rochelle) Original Article BACKGROUND: One Key Question(®) (OKQ) is a tool that embeds a patient-centered screening into routine visits with the goal of making pregnancy intention screening universal, but widespread implementation has not yet been adopted. We aimed to explore the barriers and facilitators of OKQ implementation to better understand how to best implement the tool across different settings. METHODS: We invited staff and clinicians from one obstetrics and gynecology clinic and one family medicine clinic, which previously implemented OKQ, to complete surveys and qualitative interviews about their experiences with the tool. The interview guide and thematic analysis of the interview transcripts were informed by the Consolidated Framework for Implementation Research (CFIR). MAIN FINDINGS: Major facilitators of OKQ implementation are the simplicity of the tool, engagement of clinic leadership, and compatibility between the perceived goals of the tool and those of practice staff and clinicians. Although participants indicated that OKQ had a minimal impact on clinic workflow during its implementation, preimplementation time concerns were a major barrier to implementation in both clinics. Barriers seen in the family medicine practice included OKQ distracting from the visit agenda, and concerns about the OKQ gold standard protocol of screening each patient at every visit. Participants even suggested asking OKQ only during annual check-up appointments. CONCLUSIONS: The perceived alignment between the tool's goals and those of clinic stakeholders was an important facilitator of OKQ implementation success. However, characteristics of the clinic setting, such as competing medical priorities and time constraints, influenced initial attitudes toward the feasibility of the intervention. Clinical Trial Registration Number: NCT03947788 Mary Ann Liebert, Inc., publishers 2022-03-08 /pmc/articles/PMC8994428/ /pubmed/35415707 http://dx.doi.org/10.1089/whr.2021.0100 Text en © Meron Ferketa et al., 2022; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by/4.0/This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ferketa, Meron
Schueler, Kellie
Song, Bonnie
Carlock, Francesca
Stulberg, Debra B.
White VanGompel, Emily
Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool
title Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool
title_full Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool
title_fullStr Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool
title_full_unstemmed Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool
title_short Facilitators of and Barriers to Successful Implementation of the One Key Question(®) Pregnancy Intention Screening Tool
title_sort facilitators of and barriers to successful implementation of the one key question(®) pregnancy intention screening tool
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994428/
https://www.ncbi.nlm.nih.gov/pubmed/35415707
http://dx.doi.org/10.1089/whr.2021.0100
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