Practice Facilitation Improves Adolescent Reproductive Health Preventive Services in Primary Care.

Autor:	Berlan E; Nationwide Children's Hospital, Columbus, Ohio.; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and., Valenti O; Nationwide Children's Hospital, Columbus, Ohio.; Partners For Kids, Columbus, Ohio., Long W; Nationwide Children's Hospital, Columbus, Ohio.; Partners For Kids, Columbus, Ohio., Toth C; Nationwide Children's Hospital, Columbus, Ohio., Abenaim A; Nationwide Children's Hospital, Columbus, Ohio., Maciejewski H; Nationwide Children's Hospital, Columbus, Ohio.; Partners For Kids, Columbus, Ohio., Gowda C; Nationwide Children's Hospital, Columbus, Ohio.; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and.; Partners For Kids, Columbus, Ohio.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2022 Jan 01; Vol. 149 (1).
DOI:	10.1542/peds.2020-035774
Abstrakt:	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. Competing Interests: FINANCIAL DISCLOSURE: Dr Berlan is a consultant for Merck and Bayer and a Nexplanon clinical trainer for Merck & Co., Inc. Ms Valenti, Ms Toth, Ms Maciejewski, and Dr Gowda were paid employees of Partners For Kids during the study period. Dr Long and Ms Abenaim have indicated they have no financial relationships relevant to this article to disclose. (Copyright © 2021 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu