Protocol for a process evaluation of Family Planning Elevated: a statewide initiative to improve contraceptive access in Utah (USA)

Abstract

IntroductionMany individuals in the USA do not have access to the contraceptive methods they desire. Contraceptive initiatives have emerged at the state and national levels to remove barriers to access, and many initiatives have reported success. Other initiatives may want to build on or replicate that success, but data are scarce on the details of how and why certain interventions work. This paper describes the protocol for the planned process evaluation of Family Planning Elevated (FPE), a statewide contraceptive initiative in Utah.MethodsFPE will conduct a process evaluation during the planning and implementation phases of the programme. The process evaluation will document (1) the community, state and national contexts in which the programme is implemented, (2) how FPE is implemented and (3) the mechanism by which FPE creates impact. We will collect qualitative data via interviews with FPE staff, providers and staff participating in the programme, and key stakeholders and policy-makers throughout the state. The team process evaluator will record FPE decision making and implementation activities by taking field notes during weekly FPE meetings. Quantitatively, we will collect monthly data reports from FPE-participating clinics, analytics reports from the media campaign and survey results from patients in FPE-participating clinics. The findings of the process evaluation will allow other contraceptive initiatives to learn from FPE’s efforts and replicate successful components of the programme.Ethics and disseminationThe study received approval from the University of Utah’s Institutional Review Board. Findings from the process evaluation and outcome evaluation will be published, shared with other contraceptive initiatives and presented at conferences.Trial registration numberNCT03877757.

Facility-based simulation as a programmatic tool for implementing a statewide contraceptive initiative

“…Assessments of programmatic adoption utilized summary statistics of compiled post-simulation evaluation scores. Implementation changes to the simulation were captured through our formal process evaluation, [20] which uses the CFIR framework [23].…”

“…Each training lasted four hours and involved multiple members of the clinical team, including clinical coordinators or managers, front-desk staff, medical assistants, and providers. The trainings included: 1) a 45-min discussion (a component of FPE's larger process evaluation [20]); 2) two simulation scenarios aimed at understanding a clinic's provision of key aspects of the FPE program; 3) facilitated debriefs after each scenario; and 4) an action planning session.…”

The STS case study: an analysis method for longitudinal qualitative research for implementation science

“…A pen portrait organizes data from different sources, at different time points, together in one document; it is like a collage describing one site where an innovation is being implemented [4]. Both periodic reflections [26][27][28][29] and pen portraits [30,31] have been used in the field to help develop study protocols; pen portraits have also been used as a method of data analysis [32,33]. As a novel form of LQR, the STS case study method introduces the opportunity to engage with material culture, and thus contributes a way to focus and re-focus, or calibrate, the analytic lens, or to look for how local use and understanding of the material elements of an intervention changes over time, and what that could mean for the normalization [34][35][36] of the implementation as a whole.…”