Evidence map›Paper›PMID 34270979›Full record

Trial reportContraception2021

Delivery of home-based postpartum contraception in Southwest Trifinio, Guatemala: Reach, adoption, and implementation in a cluster-randomized trial.

Margo S Harrison, Andrea Jimenez-Zambrano, Claudia Rivera, Saskia Bunge-Montes, Amy G Huebschmann

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Contraception, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Margo S HarrisonUniversity of Colorado, Aurora, CO, United States. Electronic address: margo.harrison@cuanschutz.edu.
Andrea Jimenez-ZambranoUniversity of Colorado, Aurora, CO, United States.
Claudia RiveraFundación para la Salud Integral de los Guatemaltecos, Quetzaltenango, Guatemala (FSIG).
Saskia Bunge-MontesFundación para la Salud Integral de los Guatemaltecos, Quetzaltenango, Guatemala (FSIG).
Amy G HuebschmannUniversity of Colorado, Aurora, CO, United States.

Funding

COLORADO WRHR CAREER DEVELOPMENT CENTERK12HD001271 · NICHD · UNIVERSITY OF COLORADO DENVER · PI Saketh R Guntupalli · 1999 to 2026
$8.9M
NICHD NIH HHS K12 HD001271
6 · The paper itself

Abstract

objectiveThe objective of this analysis was to present our secondary outcomes (reach, adoption, implementation, maintenance domains) of a prospective trial to test the efficacy of a home-based intervention to increase postpartum contraceptive uptake. STUDY

designWe executed a cluster-randomized trial to determine if provision of contraception in the home setting increased uptake of postpartum methods. We collected secondary outcomes on how our implementation strategies of revising professional roles and changing service sites performed in terms of the number of people our study enrolled of all women eligible (reach), how it was accepted by the providers (adoption), what methods were used to conduct the study (implementation), and preliminary results on whether or not the intervention will be continued (maintenance). We conducted a survey and focus group discussion to assess adoption and implementation among intervention nurse staff, and a survey in a convenience sample of patients in the intervention arm to assess acceptability.

resultsOur primary outcome of effectiveness has been published; implant uptake was 25% in the intervention cohort compared to 3% in the control clusters. Our reach was 89%, as 208 of the 234 eligible women consented to participate. Among a convenience sample of N = 25 patients completing a survey on the intervention 12 months after enrollment, ≥ 68% (n = 17 of 25) felt the intervention was acceptable. From the nursing perspective (N = 7), only a minority of nurses felt the intervention was complicated (n = 1, 17%), and (n = 7, 100%) reported the intervention was acceptable.

conclusionsOur intervention achieved good reach (89% of the eligible population) and was acceptable to the majority of patients and providers. Practitioners interested in achieving greater reach of contraceptive interventions in their communities may consider changing service sites to convenience their clients, as our results suggest this approach was acceptable. IMPLICATIONS: The unique contribution of this paper is in its success with training nurses to insert contraceptive implants during postpartum home visits, which resulted in increased uptake of the contraceptive implant where access to the device was previously limited. Given the trial's successful feasibility and acceptability to both nurses and patients, perhaps this intervention has the potential to be adapted and scaled to other settings.

Indexed as

ContraceptionPostpartum PeriodContraceptive AgentsFemaleGuatemalaHumansProspective StudiesContraceptive AgentsCommunity-based programmingContraceptive implantGuatemalaLong-acting reversible contraceptionPostpartum contraception

Identifiers

PMID34270979
PMCPMC8435003

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.