Elena R Fisher, Deborah Cragun, Robert F Dedrick, Crystal Y Lumpkins, Mariana Ramírez, Kimberly A Kaphingst, Ashley Petersen, Ian M MacFarlane, Krista Redlinger-Grosse, Abdirashid Shire, Kathleen A Culhane-Pera, Heather A Zierhut
Linking genetic counseling communication skills to patient outcomes and experiences using a community-engagement and provider-engagement approach: research protocol for the GC-PRO mixed methods sequential explanatory study
BMJ open
mistreatment childbirth growing concern worldwide especially developing countries iran response launched comprehensive implementation research ir project reduce mistreatment childbirth enhance positive birth experiences birth facilities study identified challenges implementing multilevel intervention reduce mistreatment women childbirth using consolidated framework implementation research cfir exploratory qualitative study involving 30 indepth interviews conducted july 2022 february 2023 participants included purposive sample key stakeholders different levels health system macro ministry health medical education meso universities medical sciences health services micro hospitals sufficient knowledge direct experience andor collaboration implementation studied interventions interviews transcribed verbatim coded using directed qualitative content analysis cfir constructs maxqda 18 identified challenges 1 individual level childbirth preparation classes eg adaptability design quality packaging cosmopolitanism presence birth companions eg patient needs resources structural characteristics culture 2 healthcare provider level integrating respectful maternity care inservice training eg relative priority access knowledge information reflecting evaluating 3 hospital level evaluating performance maternity healthcare providers eg executing external policies incentives 4 national health system level implementation pain relief childbirth guidelines eg networks communications patient needs resources executing reflecting evaluating study provides clear understanding challenges implementing multilevel intervention reduce mistreatment women childbirth highlights potential implications policy makers practitioners maternal health programs encourage take lessons learned study revise current programs policies regarding quality maternity care focusing identified challenges