Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104264

Roy Jacobstein, MD, MPH, ACQUIRE Project, EngenderHealth, 440 Ninth Avenue, New York, NY 10001, 212-561-8029, RJacobstein@engenderhealth.org

This two-part presentation is intended to be the first part of a panel designed to focus on “knowledge-to-practice” with respect to “IUD Revitalization,” an effort that is receiving renewed attention and funding from program managers and international donors. The presentation first analyzes the “so what” about recent well-documented scientific and clinical evidence regarding the IUD's high level of safety and efficacy, focusing on its: 1) length of effectiveness; 2) safety when used by HIV-infected women; 3) safety in nulliparous women; 4) extremely low attributable risk pelvic inflammatory disease (PID); and, 5) lack of causal relationship to infertility. The presentation will then consider the nature and dynamics of change, as documented over many years according to Roger's theory of “The Diffusion of Innovations,” and Berwick's application of it to medical settings. Such consideration is important because effecting change is what those of us working in development agencies “do” when we “do development,” yet the great wealth of time-tested, empirical evidence about the nature, dynamics, and “manipulability” of change is too often neglected in our development interventions—and thus well-documented scientific evidence as well as best program practices too often do not eventuate in “logical.” and/or desired, behavior change. This second part of the session will: 1) present evidence of the slow pace of change in medical/clinical settings—in both “developed” and “developing countries”; 2) analyze reasons for this slow pace of change; 3) consider specific barriers to IUD service provision; and, 4) suggest strategies to effect more rapid and sustained change.

Learning Objectives:

• At the conclusion of this session, the participant will be able to list five recent findings about the safety and efficacy of IUDs and why they are important. The participant will also be able to articulate key principles from the theory of “The Diffusion of Innovations,” and to identify practical steps that can be taken—as well as pitfalls to avoid—in light of this theory, to accelerate the pace and extent of change in “medicalized” settings as it bears upon IUD service provision.

Keywords: Contraception, Change Concepts

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation