Use of an electronic health record data sharing system for identifying current contraceptive use within the WWAMI region Practice and Research Network

Godfrey, Emily M.; West, Imara I.; Holmes, John; Keppel, Gina A.; Baldwin, Laura‐Mae

doi:10.1016/j.contraception.2018.06.005

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…If patients received care for LARC-related issues at other clinics, or lost Medicaid eligibility, continuation rates may be falsely high. While the electronic health record (EHR) was used to access contraception encounter data, the accuracy of the records has the potential for incomplete data [ 50 ], which may affect results. One such limitation is the inability of our EHR to ascertain the number of women who intended to be on LARC but were unable to obtain it and never returned.…”

Section: Discussionmentioning

confidence: 99%

Long-Acting Reversible Contraception: Placement, Continuation, and Removal Rates at an Inner-City Academic Medical Center Clinic

Runyan

Welch

Kramer

et al. 2021

JCM

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Long-Acting Reversible Contraception (LARCs) has the potential to decrease unintended pregnancies but only if women can easily access a requested method. Retrospective electronic chart review identified women desiring LARC placement over a one-year period ending 31 December 2016. Most of the 311 insertions were for family planning, with 220 new insertions and 60 replacements. Delays occurred in 38% (n = 118) of patients, averaged 5 ± 5 weeks, and 47% received interval contraception. Reasons included absence of qualified provider (n = 44, 37%), pending cultures (n = 31, 26%), and Mirena availability. Teenage LARC use favored Nexplanon whereas older women preferred Mirena (p < 0.01). Of the 11% choosing early LARC removal, a significant number were African Americans (p = 0.040) or teenagers (p = 0.048). Retention time varied by device type; most patients switched to other contraceptives. No patients experienced IUD expulsion. Understanding barriers, attempting to remedy them, and addressing the side effects associated with LARC use is of importance in this inner-city patient population in the United States.

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Section: Discussionmentioning

confidence: 99%

Long-Acting Reversible Contraception: Placement, Continuation, and Removal Rates at an Inner-City Academic Medical Center Clinic

Runyan

Welch

Kramer

et al. 2021

JCM

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“…There are several common elements to the structure of PBRNs (Hayes & Burge, 2012; Kelly, Kiger, et al, 2015; Westfall et al, 2019): (1) a mission statement, (2) selection of an overall leader (preferably a practitioner), (3) ongoing relationship with academic research partners, (4) support staff to execute research tasks (postdoctoral fellow, research assistant), (5) a board or mechanisms within agencies to gather feedback (steering committee, client advocacy groups, stakeholder boards), and (6) a set of tools or processes that are used to disseminate findings within agencies. PBRNs tend to expand in scope over time, initially focusing on everyday issues and gradually growing to take on more difficult projects with more involved methods (e.g., building shared data systems, testing system level interventions, Godfrey et al, 2018). The flexibility of the model allows stakeholders to adapt it to their context, which is part of its value.…”

Section: Pbrn Structure Leadership and Participatory Processesmentioning

confidence: 99%

Practice-Based Research Networks in Stakeholder-Driven Social Work Research

Kelly

Davis

Holguin

et al. 2020

Research on Social Work Practice

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Purpose: The field of social work is evolving toward community-engaged, stakeholder-driven research in the context of evidence-based practice (EBP) and practice-based evidence (PBE). Methods: We propose that practice-based research networks (PBRNs) are an approach to conducting stakeholder-driven research that can be uniquely valuable for the field of social work. Results: We define the concept of a PBRN and demonstrate how it can address the development of complementary agendas for service improvement, social work science, policy development and advocacy, as well as highlight the challenges and benefits of participating in a PBRN. We provide details of our experiences with a mental health–based PBRN in Los Angeles County, the Recovery-Oriented Care Collaborative, to illustrate the processes outlined and inform our recommendations. Conclusions: PBRNs are an important form of community-based participatory research, which can help the field of social work with reconciling EBPs and PBE to improve service delivery.

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“…Our research team considered potential sources to obtain contraceptive exposure data, such as regional and national practice-based or patient-centered networks, which allow data from different electronic medical record platforms to be extracted en masse through a single data sharing system. However, without a linked pharmacy database to verify contraceptive prescriptions, misclassification of contraceptive exposure was likely [ 16 ], and neither source included over-the-counter methods such as condoms or natural family planning. Most population-based data that link prior use of contraception with health outcomes in the United States use self-respondent surveys [ 17 - 21 ].…”

Section: Introductionmentioning

confidence: 99%

Web-Based Survey Piloting Process as a Model for Developing and Testing Past Contraceptive Use and Pregnancy History: Cystic Fibrosis Case Study

et al. 2023

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Background Individuals with complex, chronic diseases are now living longer, making reproductive health an important topic to address in the health care setting. Self-respondent surveys are a feasible way to collect past contraceptive use and pregnancy history to assess contraceptive safety and effectiveness. Because sensitive topics, such as contraception and pregnancy outcomes, can vary across social groups or cultures, piloting questions and evaluating survey administration procedures in the target population are necessary for precise and reliable responses before wide distribution. Objective This study aimed to develop a precise and reliable survey instrument and related procedures among individuals with cystic fibrosis regarding contraceptive use and obstetrical history. Methods We piloted and tested web-based questions related to contraceptive use and pregnancy history among 50 participants with and those without cystic fibrosis aged 18 to 45 years using a 3-tier process. Findings from each tier informed changes to the questionnaire before testing in the subsequent tier. Tier 1 used cognitive pretesting to assess question understanding and the need for memory prompts. In tier 2, we used test-retest self- and interviewer-administered approaches to assess question reliability, evaluate response missingness, and determine confidence between 2 types of survey administration approaches. In tier 3, we tested the questionnaire for clarity, time to complete, and whether additional prompts were necessary. Results In tier 1, respondents suggested improvements to the web-based survey questions and to the written and visual prompts for better recall regarding past contraceptive use. In tier 2, the test-retest reliability between self- and interviewer-administrative procedures of “ever use” contraceptive method questions was similar, with percent absolute agreement ranging between 84% and 100%. When the survey was self-administered, the percentage of missing responses was higher and respondent confidence about month and year when contraceptive methods were used was lower. Most respondents reported that they preferred the self-administered survey because it was more convenient and faster to complete. Conclusions Our 3-tier process to pilot web-based survey questions related to contraceptive and obstetrical history in our complex disease population helped us tailor content and format questions before wide dissemination to our target population. Results from this pilot study informed the subsequent larger study design to include a 10% respondent test-retest self- and interviewer-administered quality control component to better inform imputation procedures of missing data.

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Use of an electronic health record data sharing system for identifying current contraceptive use within the WWAMI region Practice and Research Network

Abstract: Quality metrics related to contraceptive use that rely on EHR data in this study's data-sharing system likely under-estimated true contraceptive use.

Cited by 8 publications

References 19 publications

Long-Acting Reversible Contraception: Placement, Continuation, and Removal Rates at an Inner-City Academic Medical Center Clinic

Long-Acting Reversible Contraception: Placement, Continuation, and Removal Rates at an Inner-City Academic Medical Center Clinic

Practice-Based Research Networks in Stakeholder-Driven Social Work Research

Web-Based Survey Piloting Process as a Model for Developing and Testing Past Contraceptive Use and Pregnancy History: Cystic Fibrosis Case Study

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