Implementation of mifepristone medical abortion in Canada: pilot and feasibility testing of a survey to assess facilitators and barriers
department or school: Applied Science, Faculty of
department or school: Medicine, Faculty of
department or school: Non UBC
department or school: Family Practice, Department of
department or school: Nursing, School of
data provider: DSpace
identifier citation: Pilot and Feasibility Studies. 2019 Nov 08;5(1):126
rights copyright: The Author(s).
creator: Devane, Courtney
creator: Renner, Regina M
creator: Munro, Sarah
creator: Guilbert, Édith
creator: Dunn, Sheila
creator: Wagner, Marie-Soleil
creator: Norman, Wendy V
issued: 2019-11-08T17:07:26Z
issued: 2019-11-08
description: Background: Direct primary care provision of first-trimester medical abortion could potentially address inequitable abortion access in Canada. However, when Health Canada approved the combination medication Mifegymiso® (mifepristone 200 mg/misoprostol 800 mcg) for medical abortion in July 2015, we hypothesized that the restrictions to distribution, prescribing, and dispensing would impede the uptake of this evidence-based innovation in primary care. We developed and pilot-tested a survey related to policy and practice facilitators and barriers to assess successful initiation and ongoing clinical provision of medical abortion service by physicians undertaking mifepristone training. Additionally, we explored expert, stakeholder, and physician perceptions of the impact of facilitators and barriers on abortion services throughout Canada. Methods: In phase 1, we developed a survey using 2 theoretical frameworks: Greenhalgh’s conceptual model for the Diffusion of Innovations in health service organizations (which we operationalized) and Godin’s framework to assess the impact of professional development on the uptake of new practices operationalized in Légaré’s validated questionnaire. We finalized questions in phase 2 using the modified Delphi methodology. The survey was then tested by an expert panel of 25 nationally representative physician participants and 4 clinical content experts. Qualitative analysis of transcripts enriched and validated the content by identifying these potential barriers: physicians dispensing the medication, mandatory training to become a prescriber, burdens for patients, lack of remuneration for mifepristone provision, and services available in my community. To assess the usability and reliability of the online survey, in phase 3, we pilot-tested the survey for feasibility. Results: We developed and tested a 61-item Mifepristone Implementation Survey suitable to study the facilitators and barriers to implementation of mifepristone first-trimeste…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/72231
note: RESEARCH Open AccessImplementation of mifepristone medicalabortion in Canada: pilot and feasibilitytesting of a survey to assess facilitators andbarriersCourtney Devane1,2, Regina M. Renner1,3, Sarah Munro1,3, Édith Guilbert1,4, Sheila Dunn1,5,Marie-Soleil Wagner1,6 and Wendy V. Norman1,3,7,8*AbstractBackground: Direct primary care provision of first-trimester medical abortion could potentially address inequitableabortion access in Canada. However, when Health Canada approved the combination medication Mifegymiso®(mifepristone 200 mg/misoprostol 800 mcg) for medical abortion in July 2015, we hypothesized that the restrictionsto distribution, prescribing, and dispensing would impede the uptake of this evidence-based innovation in primarycare. We developed and pilot-tested a survey related to policy and practice facilitators and barriers to assesssuccessful initiation and ongoing clinical provision of medical abortion service by physicians undertakingmifepristone training. Additionally, we explored expert, stakeholder, and physician perceptions of the impact offacilitators and barriers on abortion services throughout Canada.Methods: In phase 1, we developed a survey using 2 theoretical frameworks: Greenhalgh’s conceptual model forthe Diffusion of Innovations in health service organizations (which we operationalized) and Godin’s framework toassess the impact of professional development on the uptake of new practices operationalized in Légaré’s validatedquestionnaire. We finalized questions in phase 2 using the modified Delphi methodology. The survey was thentested by an expert panel of 25 nationally representative physician participants and 4 clinical content experts.Qualitative analysis of transcripts enriched and validated the content by identifying these potential barriers:physicians dispensing the medication, mandatory training to become a prescriber, burdens for patients, lack ofremuneration for mifepristone provision, and services available in my community. To as…
has type: Article
is shown at: 10.14288/1.0385136
language: eng
peer review status: Reviewed
provider: Vancouver : University of British Columbia Library
publisher: BioMed Central
publisher DOI: 10.1186/s40814-019-0520-8
rights: Attribution 4.0 International (CC BY 4.0)
rights URI: http://creativecommons.org/licenses/by/4.0/
scholar level: Faculty
subject: Mifepristone
subject: Canada
subject: Abortion
subject: Survey
subject: Family planning
subject: Family physician
subject: Delphi approach
subject: Diffusion of Innovation
subject: Implementation science
type: Text
identifier URI: http://hdl.handle.net/2429/72231