Document Type

Conference Proceeding

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Publication Title



Objectives: To assess clinicians’ perspectives on WE CARE (an emergency department (ED) family planning counseling and referral intervention that uses an online health tool and community health workers) to inform intervention design for implementation.

Methods: We conducted one-on-one, semi-structured interviews with Emergency Medicine, Family Medicine, and Obstetrics & Gynecology clinicians until thematic saturation. The Consolidated Framework for Implementation Research (CFIR) informed the interview guide and was used to code all transcripts. A CFIR expert conducted an external coding audit.

Results: We interviewed 30 clinicians (female (77%), ED staff (47%), white (63%), and attending physicians (43%)). WE CARE was highly acceptable. Dominant CFIR domains include: (1) Clinicians suggested Design Quality and Packaging modifications, particularly the referral processes, to promote successful implementation; (2) transportation and insurance were essential Patient Needs and Resources; (3) WE CARE was Compatible with the Value of “no missed opportunity” to help patients; (4) Compatibility with Work Processes – WE CARE posed scheduling and reimbursement challenges to clinics; (5) Clinicians expressed concerns about an ED Culture of reproductive health frustrations, resistance to change, and competing priorities. Others identified the ED “safety net” culture and long wait times as assets to the intervention; (6) WE CARE had a significant Relative Advantage over the status quo. A few clinicians identified more advantageous alternatives (e.g., WE CARE in the clinic, home, or community settings); (7) Engaging Key Stakeholders throughout the hospital was a critical implementation element.

Conclusions: Clinicians contextualized several implementation constructs relevant to designing and implementing an ED family planning intervention.





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