Exploring Provider Perspectives as Barriers and Facilitators to Implementation of Quality Family Planning Recommendations at Title X Clinics: A Qualitative Study

Megan Simmons, Lucia Guerra-Reyes, Beth Meyerson, Kristin Adams, Stephanie Sanders

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background In 2014, the Centers for Disease Control and Prevention and the Office of Population Affairs released a document entitled Providing Quality Family Planning Services (QFP), which outlined recommendations for delivery of family planning services using a client-centered approach. These aimed to standardize service provision and address numerous reproductive health challenges. To date, little is known about QFP implementation or the factors influencing its adoption by clinicians. Study Design Semistructured interviews were conducted with 16 family planning providers at Title X-funded clinics in Indiana and Missouri to measure provider attitudes toward the QFP, their influence on adoption of the recommendations, and other barriers to QFP implementation. Interviews were transcribed verbatim and analyzed in Nvivo. Using the diffusion of innovation theory as a framework, we identify themes related to innovation adoption. Results Findings suggest that a provider's values related to client-centered counseling and views regarding the relative advantage of the QFP are key factors influencing adoption. Participants identified a number of structural and interpersonal barriers to implementation including misinterpretation of the QFP and billing issues. Conclusions Although participants expressed that QFP was an improvement over previous guidelines, misalignment of the recommendations with professional values and experiences, lack of clarity of the guidelines, and logistical issues serve as major barriers to adoption and implementation. These findings inform our understanding of policy adoption. Increased training and precise messaging is necessary to improve adoption of QFP at Title X clinics.

Original languageEnglish (US)
Pages (from-to)628-633
Number of pages6
JournalWomen's Health Issues
Volume26
Issue number6
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Health(social science)
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Maternity and Midwifery

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