Responsive design, local realities: A process evaluation of Family Planning Elevated

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2026-03-01 Epub Date: 2025-10-27 DOI:10.1016/j.contraception.2025.111277

Jami Baayd, Caitlin Quade, Alexandra Gero, Jessica N. Sanders, Rebecca G. Simmons

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引用次数: 0

Abstract

Objectives

While the ability of contraceptive initiatives to improve access has been established, less is known about the process of implementing them within health settings. To address this gap, we conducted a process evaluation of Family Planning Elevated (FPE), a statewide contraceptive initiative in Utah.

Study design

FPE partnered with 28 clinics to provide no-cost contraceptive care to individuals across Utah. We conducted a mixed methods process evaluation to document how FPE was implemented, how surrounding context affected the implementation, and the mechanisms by which FPE created impact. Our primary data sources were baseline, midline, and endline focus groups with clinic staff, which we analyzed using the Consolidated Framework for Implementation Research and qualitative longitudinal analysis.

Results

Our evaluation yielded six themes: Utah’s reproductive health landscape (1) and the Covid pandemic (2) significantly impacted FPE’s implementation, (3) FPE’s adaptability was crucial to successful implementation, (4) structural characteristics of clinics were a common barrier to implementation, (5) clinic partners were motivated to participate in FPE, despite its complexity, because of the benefit to their clients and (6) provider perspectives and organizational culture became more person-centered during FPE.

Conclusions

Findings from FPE’s process evaluation point to the importance of designing a program that is adaptable to shifting local, state, and national context, as well as to the unique needs of each clinic. Clinic partners were committed to expanding contraceptive access through FPE, and during their participation, clinic staff’s perspectives shifted towards a more person-centered approach and culture.

Implications

Success of this initiative was driven by the ability of the FPE program to tailor the intervention to meet unique clinic and community needs, and by the commitment of clinic partners to expand contraceptive access for their clients.

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响应式设计，地方现实：计划生育提升的过程评价。

目标：虽然已经确立了避孕措施改善获取的能力，但对在卫生机构内实施这些措施的过程了解较少。为了解决这一差距，我们对犹他州的一项全州范围内的避孕倡议——计划生育提升计划（FPE）进行了过程评估。研究设计：FPE与28家诊所合作，为犹他州的个人提供免费避孕护理。我们进行了一项混合方法过程评估，以记录FPE是如何实施的，周围环境是如何影响实施的，以及FPE产生影响的机制。我们的主要数据来源是基线、中线和终线焦点小组与诊所工作人员，我们使用实施研究统一框架和定性纵向分析进行分析。结果：我们的评估产生了六个主题：犹他州的生殖健康状况（1)和Covid大流行(2)显著影响了FPE的实施，3）FPE的适应性对成功实施至关重要，4)诊所的结构特征是实施的常见障碍，5)尽管FPE很复杂，但诊所合作伙伴仍有动力参与FPE，因为他们的客户受益，6)在FPE期间，提供者的观点和组织文化变得更加以人为中心。结论：FPE的过程评估结果表明，设计一个适应当地、州和国家环境变化的方案以及每个诊所的独特需求的重要性。诊所合作伙伴致力于通过FPE扩大避孕药具的获取，在他们参与期间，诊所工作人员的观点转向了更加以人为本的方法和文化。影响：这一举措的成功是由于FPE项目有能力定制干预措施以满足独特的诊所和社区需求，以及诊所合作伙伴承诺扩大其客户获得避孕药具的机会。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.