Online Program

Getting the best evidence: A systematic review of strategies to disseminate and implement family planning guidelines into primary care

Wednesday, November 4, 2015

Michael Nguyen, MPH, School of Medicine, University of Washington, Seattle, WA
Emily Godfrey, MD, MPH, Department of Family Medicine, University of Washington, Seattle, WA
Sarah Safranek, MLIS, Health Sciences Library, University of Washington, Seattle, WA
Miruna Petrescu-Prahova, PhD, Health Promotion Research Center, University of Washington, Seattle, WA
Background.  The Affordable Care Act transitioned family planning into primary care.  Most guidelines take about 17 years to implement, preventing patients from receiving quality care.  Because practice guidelines have proliferated, understanding how best to disseminate and implement them is needed, in order to optimize individual and population health.

Purpose.  To assess the evidence for dissemination and implementation strategies related to family planning clinical practice guidelines within primary care.

Methods.  We conducted a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.  PubMed, Embase, CINAHL and POPLINE databases were searched.  Included articles evaluate one or more strategies, for at least one outcome.  These articles were abstracted using the Agency for Healthcare Research Quality standard form.

Findings.  2,329 articles were identified.  After applying inclusion criteria, one RCT, one comparative study, one observational study, and four pre-/post-survey evaluation were included.  The types of interventions used in this studies included:  continuing education, training workshops, electronic medical record provider prompts, patient-facilitated prompts, and lectures.  The outcome measures included:  knowledge of recommendations, attitude about perceived barriers to implementing guidelines, change in provider prescribing habits, and clinical skills.  These interventions demonstrated some effectiveness.

Significance.  While several intervention types were used, there is limited strong evidence about which intervention types are most effective.  The diversity of measures makes comparative effectiveness difficult.  This review highlights the importance of developing standardized measures for determining successful dissemination and implementation practices.  Further research is needed to determine evidence-based strategies dissemination and implementation of family planning practice guidelines.

Learning Areas:

Clinical medicine applied in public health
Other professions or practice related to public health
Provision of health care to the public
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe at least 1 reason that dissemination and implementation of family planning practice guidelines is important to population health List 3 strategies used to disseminate family planning practice guidelines Name at least 1 methodological issue with current research about dissemination and implementation of family planning practice guidelines

Keyword(s): Family Planning, Medical Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a Masters of Public Health and have taken coursework related to matter of maternal and child health. I have extensive experience conducting systematic reviews on numerous topics. I am current medical student at the University of Washington.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.