Practice Facilitation Improves Adolescent Reproductive Health Preventive Services in Primary Care

PEDIATRICS ◽  
2021 ◽  
Author(s):  
Elise Berlan ◽  
Olivia Valenti ◽  
William Long ◽  
Christina Toth ◽  
Angela Abenaim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Reproductive Health ◽  
Low Income ◽  
Preventive Services ◽  
Care Quality ◽  
Care Organization ◽  
Practice Facilitation ◽  
National Guidelines ◽  
Adolescent Reproductive Health

OBJECTIVES: Provision of reproductive health preventive services to adolescents is critical given their high rates of sexually transmitted infections and unintended pregnancies. Pediatricians are well positioned to provide these services but often face barriers. With this project, we aimed to build quality improvement (QI) capacity within pediatric practices to improve adherence to national guidelines for adolescent reproductive health preventive services. METHODS: In 2016, an accountable care organization overseeing health care delivery for low-income children in the Midwestern United States used practice facilitation, a proven approach to improve health care quality, to support pediatric practices in implementing reproductive health QI projects. Interested practices pursued projects aimed at providing (1) sexual risk reduction and contraceptive counseling (reproductive health assessments [RHAs]) or (2) etonogestrel implants. QI specialists helped practices build key driver diagrams and implement interventions. Outcome measures included the proportion of well-care visits with RHAs completed and number of etonogestrel insertions performed monthly. RESULTS: Between November 1, 2016, and December 31, 2019, 6 practices serving >7000 adolescents pursued QI projects. Among practices focused on RHAs, the proportion of well-care visits with completed RHAs per month increased from 0% to 65.8% (P < .001) within 18 months. Among practices focused on etonogestrel implant insertions, overall insertions per month increased from 0 to 8.5 (P < .001). CONCLUSIONS: Practice facilitation is an effective way to increase adherence to national guidelines for adolescent reproductive health preventive services within primary care practices. Success was driven by practice-specific customization of interventions and ongoing, hands-on support.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

scholarly journals Primary Care Physicians’ Perceptions of Barriers To Preventive Reproductive Health Care In Rural Communities

2012 ◽  
Vol 44 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Cynthia H. Chuang ◽  
Sandra W. Hwang ◽  
Jennifer S. McCall-Hosenfeld ◽  
Lara Rosenwasser ◽  
Marianne M. Hillemeier ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Rural Communities ◽  
Reproductive Health ◽  
Primary Care Physicians ◽  
Reproductive Health Care

EFFECTIVE OF INTERVENTION SOLUTIONS TO IMPROVE SITUATION OF REPRODUCTIVE HEALTH CARE AMONG ADOLESCENT GIRLS IN A LUOI DISTRICT, THUA THIEN HUE PROVINCE

2020 ◽  
pp. 32-44
Author(s):  
Trang Dao Nguyen Dieu ◽  
Huy Nguyen Vu Quoc ◽  
Thanh Cao Ngoc ◽  
Ngoc Phan Thi Bich
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Adolescent Girls ◽  
Study Design ◽  
Good Practice ◽  
Education Level ◽  
Control Group ◽  
Health Staff ◽  
Reproductive Health Care ◽  
Adolescent Reproductive Health

Objectives: To describe the knowledge, attitudes, practices of reproductive health care among adolescent girls in A Luoi district, Thua Thien Hue province and to identify the related factors to reproductive health care in adolescent girls. To assess the results of intervention solutions of reproductive health care in adolescent girls. Methods: A cross-sectional study design. A study design for community intervention comparision with control group. Results: The percentage of adolescents with not good knowledge, attitudes and practices on reproductive health care has accounted for fairly high as respectively: 85.9%, 73.9%, 72.9%. There is an a relationship between education level, adolescent stage with general knowledge on adolescent reproductive health care (p < 0.05). There is a relationship between ethnicity, education level, adolescent stage with the general attitude on adolescent reproductive health care (p < 0.05). There is a relationship between knowledge, attitude, education level, adolescent stage, economic condition, the condition of the family living at the percentage of general practice on adolescent reproductive health care (p < 0.05). The effective of intervention: Good knowlegde increase from 10% to 24.1%. Good attitude increase from 16.7% to 61.4%. Good practice increase from 27.1% to 42.9%. The effective of intervention: change knowlegde: 21.6%, change attitude: 54.2%, change practice: 34.6%. Conclusion: There is need to enhance the communication and education reproductive health for aldolescent girls and to enhance communication knowlegde and skills for reproductive health staff. Keywords: adolescents, get married early, reproductive health.

scholarly journals Adolescent Reproductive Health Care: Views and Practices of Pediatric Hospitalists

2019 ◽  
Vol 9 (2) ◽  
pp. 100-106 ◽  
Author(s):  
Abbey R. Masonbrink ◽  
Stephani Stancil ◽  
Kimberly J. Reid ◽  
Kathy Goggin ◽  
Jane Alyce Hunt ◽  
...  
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Reproductive Health Care ◽  
Adolescent Reproductive Health

scholarly journals Development and validation of the Vietnamese Primary Care Assessment Tool – provider version

2019 ◽  
Vol 20 ◽  
Author(s):  
Nguyen Thi Hoa ◽  
Anselme Derese ◽  
Jeffrey F. Markuns ◽  
Nguyen Minha Tam ◽  
Wim Peersman
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Internal Consistency ◽  
Assessment Tool ◽  
Care Quality ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
The Impact ◽  
Primary Care Assessment Tool

Abstract Aim: To adapt the provider version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity. Background: There is a growing need to measure and explore the impact of various characteristics of health care systems on the quality of primary care. It would provide the best evidence for policy makers if these evaluations come from both the demand and supply sides of the health care sector. Comparatively more researchers have studied primary care quality from the consumer perspective than from the provider’s perspective. This study aims at the latter. Method: Our study translated and adapted the PCAT provider version (PCAT PE) into a Vietnamese version, after which a cross-sectional survey was conducted to examine the feasibility, internal consistency and validity of the Vietnamese PCAT provider version (VN PCAT PE). All general doctors working at 152 commune health centres in Thua Thien Hue province had been selected to participate in the survey. Findings: The VN PCAT PE is an instrument for evaluation of primary care in Vietnam with 116 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. From the translation and cultural adaptation stage, two items were combined, two items were removed and one item was added. Six other items were excluded due to problems in item-total correlations. All items have a low non-response or ‘don’t know/don’t remember’ response rate, and there were no floor or ceiling effects. All scales had a Cronbach’s alpha above 0.80, except for the Coordination scale, which still was above the minimum level of 0.70. Conclusion: The VN PCAT PE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the provider perspective.

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