Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol

• Autores: Bohren, Meghan A.; Lorencatto, Fabiana; Coomarasamy, Arri; Althabe, Fernando; Devall, Adam J.; Evans, Cherrie; Oladapo, Olufemi T.; Lissauer, David; Akter, Shahinoor; Forbes, Gillian; Thomas, Eleanor; Galadanci, Hadiza; Qureshi, Zahida; Fawcus, Sue; Hofmeyr, G. Justus; Al-beity, Fadhlun Alwy; Kasturiratne, Anuradhani; Kumarendran, Balachandran; Mammoliti, Kristie Marie; Vogel, Joshua P.; Gallos, Ioannis; Miller, Suellen
• Año de publicación: 2021
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: BEHAVIOR CHANGE; CARE BUNDLE; FORMATIVE RESEARCH; IMPLEMENTATION; INTERVENTION DEVELOPMENT; MATERNAL HEALTH; MATERNAL MORTALITY; OBSTETRIC HEMORRHAGE; POSTPARTUM HEMORRHAGE
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Background: Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. When PPH occurs, early identification of bleeding and prompt management using evidence-based guidelines, can avert most PPH-related severe morbidities and deaths. However, adherence to the World Health Organization recommended practices remains a critical challenge. A potential solution to inefficient and inconsistent implementation of evidence-based practices is the application of a ‘clinical care bundle’ for PPH management. A clinical care bundle is a set of discrete, evidence-based interventions, administered concurrently, or in rapid succession, to every eligible person, along with teamwork, communication, and cooperation. Once triggered, all bundle components must be delivered. The E-MOTIVE project aims to improve the detection and first response management of PPH through the implementation of the “E-MOTIVE” bundle, which consists of (1) Early PPH detection using a calibrated drape, (2) uterine Massage, (3) Oxytocic drugs, (4) Tranexamic acid, (5) Intra Venous fluids, and (6) genital tract Examination and escalation when necessary. The objective of this paper is to describe the protocol for the formative phase of the E-MOTIVE project, which aims to design an implementation strategy to support the uptake of this bundle into practice. Methods: We will use behavior change and implementation science frameworks [e.g. capability, opportunity, motivation and behavior (COM-B) and theoretical domains framework (TDF)] to guide data collection and analysis, in Kenya, Nigeria, South Africa, Sri Lanka, and Tanzania. There are four methodological components: qualitative interviews; surveys; systematic reviews; and design workshops. We will triangulate findings across data sources, participant groups, and countries to explore factors influencing current PPH detection and management, and potentially influencing E-MOTIVE bundle implementation. We will use these findings to develop potential strategies to improve implementation, which will be discussed and agreed with key stakeholders from each country in intervention design workshops. Discussion: This formative protocol outlines our strategy for the systematic development of the E-MOTIVE implementation strategy. This focus on implementation considers what it would take to support roll-out and implementation of the E-MOTIVE bundle. Our approach therefore aims to maximize internal validity in the trial alongside future scalability, and implementation of the E-MOTIVE bundle in routine practice, if proven to be effective.
Fil: Bohren, Meghan A.. Melbourne School Of Population And Global Health; Australia
Fil: Lorencatto, Fabiana. Colegio Universitario de Londres; Reino Unido
Fil: Coomarasamy, Arri. University Of Birmingham; Reino Unido
Fil: Althabe, Fernando. Organizacion Mundial de la Salud; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Devall, Adam J.. University Of Birmingham; Reino Unido
Fil: Evans, Cherrie. University Johns Hopkins; Estados Unidos
Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; Argentina
Fil: Lissauer, David. Queen Elizabeth Central Hospital; Malaui. University of Liverpool; Reino Unido
Fil: Akter, Shahinoor. Melbourne School Of Population And Global Health; Australia
Fil: Forbes, Gillian. Colegio Universitario de Londres; Reino Unido
Fil: Thomas, Eleanor. University Of Birmingham; Reino Unido
Fil: Galadanci, Hadiza. Bayero University; Nigeria
Fil: Qureshi, Zahida. University Of Nairobi Medical School; Kenia
Fil: Fawcus, Sue. Groote Schuur Hospital; Sudáfrica
Fil: Hofmeyr, G. Justus. University Of Botswana; Botsuana. University of the Witwatersrand; Sudáfrica. Walter Sisulu University; Sudáfrica
Fil: Al-beity, Fadhlun Alwy. Muhimbili University Of Health And Allied Sciences; Tanzania
Fil: Kasturiratne, Anuradhani. University Of Kelaniya; Sri Lanka
Fil: Kumarendran, Balachandran. University Of Jaffna; Sri Lanka
Fil: Mammoliti, Kristie Marie. University Of Birmingham; Reino Unido
Fil: Vogel, Joshua P.. Burnet Institute; Australia
Fil: Gallos, Ioannis. University Of Birmingham; Reino Unido
Fil: Miller, Suellen. Ucsf School Of Medicine; Estados Unidos