Model fidelity of group antenatal and postnatal care: a process analysis of the first implementation of this innovative service model by the Preterm Birth Initiative-Rwanda.

Autor:	Butrick E; Institute for Global Health Sciences, University of California San Francisco, San Franciso, CA, 94158, USA., Lundeen T; Institute for Global Health Sciences, University of California San Francisco, San Franciso, CA, 94158, USA., Phillips BS; Institute for Global Health Sciences, University of California San Francisco, San Franciso, CA, 94158, USA., Tengera O; School of Nursing and Midwifery, National University of Rwanda, Kigali, Rwanda., Kambogo A; Rwanda Nurses and Midwives Union, Kigali, Rwanda., Uwera YDN; School of Nursing and Midwifery, National University of Rwanda, Kigali, Rwanda., Musabyimana A; School of Public Health, National University of Rwanda, Kigali, Rwanda., Sayinzoga F; Maternal, Child and Community Health Division, Rwanda Biomedical Center, Kigali, Rwanda., Nzeyimana D; School of Public Health, National University of Rwanda, Kigali, Rwanda., Murindahabi N; School of Public Health, National University of Rwanda, Kigali, Rwanda., Musange S; School of Public Health, National University of Rwanda, Kigali, Rwanda., Walker D; Institute for Global Health Sciences, University of California San Francisco, San Franciso, CA, 94158, USA.
Jazyk:	angličtina
Zdroj:	Gates open research [Gates Open Res] 2020 Jan 07; Vol. 4, pp. 7. Date of Electronic Publication: 2020 Jan 07 (Print Publication: 2020).
DOI:	10.12688/gatesopenres.13090.1
Abstrakt:	Background: For a large trial of the effect of group antenatal care on perinatal outcomes in Rwanda, a Technical Working Group customized the group care model for implementation in this context. This process analysis aimed to understand the degree of fidelity with which the group antenatal care model was implemented during the trial period. Methods: We used two discreet questionnaires to collect data from two groups about the fidelity with which the group antenatal care model was implemented during this trial period. Group care facilitators recorded descriptive data about each visit and self-assessed process fidelity with a series of yes/no checkboxes. Master Trainers assessed process fidelity with an 11-item tool using a 5-point scale of 0 (worst) to 4 (best). Results: We analyzed 2763 questionnaires completed by group care facilitators that documented discreet group visits among pregnant and postnatal women and 140 questionnaires completed by Master Trainers during supervision visits. Data recorded by both groups was available for 84 group care visits, and we compared these assessments by visit. Approximately 80% of all group visits were provided as intended, with respect to both objective measures (e.g. group size) and process fidelity. We did not find reliable correlations between conceptually-related items scored by Master Trainers and self-assessment data reported by group visit facilitators. Conclusions: We recommend both the continued participation of expert observers at new and existing group care sites and ongoing self-assessment by group care facilitators. Finally, we present two abbreviated assessment tools developed by a Rwanda-specific Technical Working Group that reviewed these research results. Competing Interests: No competing interests were disclosed. (Copyright: © 2020 Butrick E et al.)
Databáze:	MEDLINE
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